So, you have definitely heard us at NLIRH talk about the awesome provision of health reform that requires a wide range of preventive health services to be covered by private insurance plans with no additional costs to patients.
And while we have celebrated many times over the decision that contraception will be one of the covered preventive services, today I would like to focus on another bucket of services that will be covered under their private health insurance at no additional cost: pregnancy-related preventive health care.
Because of health reform, on September 23, 2010 private health insurance plans began providing coverage for the below listed pregnancy-related preventive health care at no additional cost :
- Prenatal vists
- Alcohol and tobacco counseling
- Rh incompatibility screening: Rh incompatibility is a condition that develops when a pregnant woman has Rh-negative blood and the baby in her womb has Rh-positive blood. If not prevented or treated, this condition could cause brain damage to newborn.
- Screenings for Hepatitis B, Chlamydia, Gonorrhea, Syphilis and Bacteriurea: Hepatitis B is a viral infection of the liver; chlamydia, gonorrhea and syphilis are sexually transmitted infections; bacteriurea is the presence of bacteria in the urine which can cause low-birth weight or premature birth for newborns.
- Folic Acid Supplements: These supplements help reduce the risk of birth defects.
- Iron deficiency anemia screening
- Breastfeeding counseling
And under the Women’s Health Amendment, a number of women’s preventive services related to pregnancy care will be covered without co-payments, deductibles or co-insurance starting August 1, 2012.
- Screening for gestational diabetes at 24-28 weeks of gestation and at the first prenatal visit for women who have been determined to be high-risk for gestation diabetes.
- Breastfeeding consultation with trained provider and equipment rental
Are there any “catches?” How do I know this applies to me?
All private health insurance plans – including individual, small group, large group and self-insured plans- must comply with this reform on the beginning of their first “plan year” after September 23, 2010.
The plans excluded are what they call “grandfathered plans,” or plans that have been in effect before March 23, 2010 and do not drastically change their coverage (for example, by covering fewer services or charging more for preventive care.) However, with each year that passes, more and more “grandfathered plans” will lose this status and will have to comply with the new rules for covering these services. The Department of Health and Human Services has estimate that by 2013, 45% of large group plans and 66% of small group plans will lose grandfathered status.
Why is no co-pay for these services important to Latinas?
Before health reform, the number and costs of deductibles, co-payments and co-insurance charges created situations where Latinas would have to choose between preventive care and paying for things like groceries, school supplies, rent and school. These changes mean that Latinas will get more out of their health insurance.
Additionally, and we will talk more about this in future posts, but as private health insurance becomes more accessible to Latin@ families through the creation of state health insurance exchanges and other affordability mechanisms, more Latinas will have access to the preventive care needed to stay healthy.
Stay tuned tomorrow for another edition of 20 DAYS of ACA!