The Affordable Care Act mandates that new insurance plans provide 19 free, preventive health services for women. In the past, many health plans covered some or all of these services, but they often required cost-sharing (e.g., copays). Now—as long as these services are administered by a provider in your network—they are free of charge. They do not incur copays or coinsurance, regardless of the type of health insurance you have, and are free whether or not you’ve met your annual deductible.
The following is a list of these services. Most are available to all women, but some do have eligibility requirements based on age or certain conditions such as pregnancy.
1. Anemia screening
This screening is available for pregnant women on a routine basis. About half of pregnant women are anemic, due to the iron needs of a growing baby, and so it’s probably a good idea to ask your provider to test you for anemia during your first prenatal visit.
2. Breast cancer genetic test counseling (BRCA)
If you’re a woman with a family history (e.g., two or more first-degree relatives) of breast cancer or ovarian cancer, you should ask a trained medical professional about whether to get genetic testing. If your provider recommends it, they will test for mutations in the BRCA gene and can counsel you on whether taking certain medications to lower your risk is right for you.
3. Breast cancer mammography screening
Women over 40 should start getting annual mammograms, and women over 50 should get mammograms every two years. Talk to your doctor to determine how often you, personally, should get a mammogram.
4. Breast cancer chemoprevention
Your provider can counsel you about medications to lower your breast cancer risk. Your plan will also cover you if you choose to go ahead with these cancer-prevention medications. There are currently two FDA-approved drugs—tamoxifen and raloxifene—that may lower your risk of breast cancer, if you have a significant family history of breast cancer or ovarian cancer.
5. Comprehensive breast-feeding support and counseling from trained providers
Pregnant and nursing women can get help with several aspects of breast-feeding, including buying or renting breast pumps, guidance on which pump to use and general medical information and recommendations.
6. Cervical cancer screening
Sexually active women should have regular cervical cancer screening tests every three to five years depending on your age and how often you get HPV tests. Cervical cancer deaths are preventable if women get regular Pap tests and abnormal cells are found before they turn into cancer. Pap tests should be administered every three years, and can be provided during your well-woman visits.
7. Screening and counseling for sexually transmitted infections
For sexually active or high-risk women, STI testing and prevention counseling is available for:
FDA-approved birth control, sterilization procedures and counseling as prescribed by your provider are covered under the Affordable Care Act, unless your health plan is sponsored by certain exempt employers. Abortifacients are not covered.
9. Domestic and interpersonal violence screening and counseling
All women can receive free and confidential services from domestic violence agencies. These agencies can then direct you to hotlines for free counseling and resources for housing, lawyers or anything survivors might need.
10. Folic acid supplements
Women of childbearing age need additional folic acid to prevent birth defects. If you’re planning on having a child, your doctor can prescribe folic acid supplements for your, or you can find them over the counter.
11. Gestational diabetes screening
Women at high risk of developing gestational diabetes and pregnant women between 24 and 28 weeks should have gestational diabetes screenings.
12. Hepatitis B screening
Like most other prenatal tests, Hepatitis B screening is covered. Hepatitis B can be passed onto your child during birth. If you’re a pregnant woman with Hepatitis B, your baby will be provided two shots soon after birth to prevent him or her from acquiring Hepatitis B.
13. HIV screening and counseling
Every woman between the ages of 15 and 65 needs to get an HIV test at least once, especially if they’re sexually active. All pregnant women should also get tested and receive the necessary treatment to prevent HIV transmission from mother to child. If you engage in high-risk behaviors, you should get tested every three to six months.
14. Human papillomavirus DNA test
This can be done in concert with the cervical cancer screening during your Pap test, which in turn can be done during your well-woman visit. If you’re not at high risk, you should be tested every three years once you turn 30. Speak your provider to determine how often you should be tested.
15. Osteoporosis screening
Women over 60 or at high risk for osteoporosis should have a bone-density test done every two years. The test is a noninvasive, imaging scan.
16. Rh incompatibility screening and follow-up
This is another prenatal test that all pregnant women should have. Rh compatibility refers to whether both you and your child have Rh factor, a protein on red blood cells. Rh factor is inherited genetically, and most people are Rh-positive. If you have Rh factor, you’re Rh-positive; if you don’t, you’re Rh-negative. Being one or the other does not have negative implications on your general health and well-being.
If you happen to be Rh-negative and your baby inherits their other parent’s Rh-positive gene—this is Rh incompatibility—your body will react to your baby’s blood as it would to a foreign body. The antibodies produced in response usually won’t affect your first pregnancy, but will cause serious problems in subsequent pregnancies. Therefore, it’s important to have both the screening test and follow-up tests.
17. Tobacco use screening and intervention
This service is free for all women. Expectant mothers are provided expanded counseling for tobacco cessation.
18. Urinary tract or other infection screening
Doctors and midwives can check the blood and urine of pregnant women for urinary tract infections, past rubella infections and STDs.
19. Well-woman visit
All women under 65 should have a well-woman visit every year. These visits provide age- and developmentally appropriate care, and often provide other preventive services as well.
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