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The Patient Protection and Affordable Care Act (otherwise known as health reform) provides several benefits of interest to women.
First, preventive care is free. This includes your annual exams, screening mammogram, colon cancer screenings, and other preventive measures. No deductible or co-pays apply as long as the service is entirely preventive. If, for example, you have Crohn’s disease like I do, it’s unlikely that a colonoscopy would ever be considered screening rather than diagnostic. But truly preventive care is free.
Second, there can be no pre-existing condition exclusions for children under age 19. Unfortunately, some insurers have, as a result, stopped selling child-only policies, which undermines this benefit. However, child-only policies are still available in many states, and if you have insurance through work or a family policy that previously excluded your child because she has a pre-existing condition, you now can add that child to your policy.
Third, children up to age 26 can stay on their parent’s insurance. If your child aged out of your policy at age 19 or 21, they now have the right to re-join your policy.
In addition, you can choose your gynecologist as your primary care physician, and in any event, you do not need a referral to see your gynecologist.
If you have been uninsured for at least six months, even if you have pre-existing conditions, you are eligible for the new Pre-Existing Condition Insurance Plan (PCIP). These plans may be run by your state or by the federal government if your state chose not to operate its own plan.
Further, lifetime limits on benefits have been eliminated, and annual limits on benefits are being phased out. This is true for all plans unless they have received a waiver from the federal government. Some “mini-med” plans, like those offered to employees at McDonalds and other large, low-wage employers, were granted waivers because some coverage is thought to be better than none, and employers who offer these limited benefit plans would have eliminated them in the absence of a waiver because eliminating benefits limits would have increased premiums dramatically.