Under the Affordable Care Act, certain preventive services that have strong scientific evidence of their health benefits must be covered (by non-grandfathered private plans) and plans can no longer charge enrollees a copayment, coinsurance or deductible for these services (though a network plan may impose cost-sharing for receiving them out-of-network if they are available in-network). These services include those that are given an “A” or “B” rating by the United States Preventive Services Task Force (USPSTF), such as mammograms and cervical cancer screenings.
Additional coverage guidelines take into account the unique health needs of women throughout their lifespans and include breastfeeding support and supplies, contraception, prenatal care and other services. They must be covered by health plans without cost sharing. The health plan coverage guidelines, developed by the Institute of Medicine (IOM) and adopted by the Department of Health and Human Services will help ensure that women receive a comprehensive set of preventive services without having to pay a co-payment, co-insurance or a deductible. The Women’s Preventive Services guidelines are found here.
Frequently Asked Questions about Women’s Preventive Services are found here.
More information on coverage of women’s preventive services can be found here.