The Affordable Care Act is a complex set of health care laws, making it that much more important to understand how the new changes affect you. Here’s what women need to know about the Affordable Care Act and some of its more recent parts that have taken effect.
Here’s what the Affordable Care Act does for you
As new laws take effect under the Affordable Care Act, you may be wondering how the changes in the health care industry affect you. Here’s what you need to know to make sure you get the most out of the Affordable Care Act.
Preventive services are covered
The Affordable Care Act helps make prevention attainable and affordable for women by requiring most health plans to cover a set of preventive services at no cost. All Marketplace plans and many other plans will cover these preventive services without charging you a copayment or coinsurance if you use a network provider, said Mark Colwell, director of consumer marketing at GoHealth.
These services include breast cancer genetic test counseling, mammography screenings, breastfeeding comprehensive support and counseling and well woman visits. Other screenings, such as for depression, alcohol and other substance abuse, are covered as well.
Birth control is covered
Under the Affordable Care Act, plans are required to cover contraceptive methods and counseling when prescribed by a health care provider.
“Plans are required to cover the services without charging a copayment, coinsurance or deductible when using an in-network provider,” Colwell said.
These covered methods include barrier methods, hormonal methods, implanted devices, emergency contraception and sterilization procedures. Are you done having children? Sterilization procedures also will be covered, Colwell said.
You have more freedoms
Depending on the plan you choose, you may be able to choose from more doctors or keep the doctor you currently see.
“You also have the freedom to choose from any primary care provider, ob-gyn or pediatrician in your health plan’s network without a referral,” Colwell said. “You now have the choice to select from a greater list of doctors to find a provider who best fits your needs or keep the ones in which you have an established relationship.”
You are equal
Women can no longer be charged more for coverage because of their gender. All health insurance plans will be prohibited from refusing to cover you because of your gender as well, Colwell said.
“In the past, insurance carriers were allowed to charge women more due to gender-specific costs, like maternity care,” he said.
Maternity coverage guaranteed
Are you pregnant or considering becoming pregnant? Colwell says health plans can no longer refuse you coverage or charge you more because you’re pregnant.
“Health plans must also cover free preventive care like gestational diabetes screening and breastfeeding support for women, and well baby visits and vaccines for children,” he said.
Essential benefits such as pregnancy and newborn care are both covered, as well as vision and dental care for children — something every mother should know about.
Women who purchase insurance in the individual Marketplace are now guaranteed access to maternity care as well. “Before the Affordable Care Act went into effect, women often had to go without maternity benefits,” Colwell said. “Women are now able to get all of the maternity care and coverage they need.”
Pre-existing condition no longer a reason to deny
Health insurance plans can no longer refuse to cover or charge more because of a pre-existing health condition, Colwell said. “Additionally, once you have insurance, the insurance company can’t refuse to cover treatment for pre-existing conditions.”