In March 2010, President Obama signed the Affordable Care Act (ACA) into law, requiring that Marketplace plans cover preventive care services. Thanks to an additional provision of the ACA, preventive health and wellness services for women were made more accessible than ever in August 2012 — from check-ups and routine screenings to specialty services for pregnant women.
When this provision took full effect, non-grandfathered plans (“plans or policies created or sold after March 23, 2010, or older plans or policies that have been changed in certain ways since that date”) were mandated to provide no-cost, expanded coverage. In other words, under these types of plans, preventive care services for women became free.
In this article, we’re going 1. define preventive care, and 2. take a deeper dive into what types of preventive care services are offered to all women who enroll in a Marketplace plan.
What is preventive care?
So what are the more common preventive care services women should take advantage of?
- Well-woman visit: women over 18 are recommended to have this annual preventive check-up, in order to receive an overall wellness assessment and any recommendations for future care. A well-woman visit will typically consist of a routine physical and, depending on sexual activity and age, could also include STI screening and counseling, a pelvic exam/pap smear, a breast exam, and a mammogram.
- Contraception: all government-approved contraception is free to covered women. Learn more from the full list of covered contraceptives. This includes methods such as birth control pills and implant devices. Note: employers citing religious affiliation are not required to pay for birth control. Contact your insurance provider for more information regarding contraception.
- STI screening and counseling: sexually active women can receive annual screening and counseling on sexually transmitted infections, including but not limited to HPV, HIV, chlamydia, gonorrhea, and syphilis.
- Domestic violence screening and counseling: this service is provided for all adolescent and adult women. The CDC notes that 1 in 3 women will experience intimate partner violence in their lifetime. Annual screenings to identify the signs of abuse can help prevent it in the future.
- Breast cancer prevention, including genetic testing for women considered to be high risk. This also includes mammograms every 1-2 years for women over 40, and chemoprevention counseling for women considered to be high risk.
- Osteoporosis screening for all women over 60. One in two women will experience complications (often a broken bone) from osteoporosis in their lifetime, making this an invaluable free service.
- Tobacco use screening and interventions.
Like we discussed above, STI prevention counseling and screening are available for sexually active women.
- Birth control methods including diaphragms, sponges, birth control pills, vaginal rings, IUDs, and other implants.
- Cervical cancer screenings are recommended for women between 21-65, every three years in combination with a pap smear.
- Screening for chlamydia, gonorrhea, HPV, HIV, syphilis, and more.
Women who are pregnant or are trying to become pregnant require specific care. These are the preventive services offered to them through Marketplace plans.
- Anemia screening throughout the pregnancy.
- Other screenings will occur at different stages of pregnancy. Women will be tested for Hepatitis B and Rh incompatibility at the first prenatal visit, and gestational diabetes between 24-28 weeks.
- Breastfeeding education, counseling, and supplies.
- Sterilization procedures.
- Supplements for pregnant women, including folic acid.
- Testing for infections of the urinary tract.
It’s important to raise awareness around all of the free preventive services available to women with Marketplace plans. After all, there are common misconceptions that free preventive health care for women begins and ends with the “well-woman visit”. We hope this article showed you that there are so many more benefits to take advantage of!
As always, speak with your plan provider for more information with regards to your specific coverage. Factors such as age and risk factor may affect copayment or coinsurance for certain services.