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Health Reform Benefits for Women

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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. But these waivers will expire in 2014, when premium tax credits or subsidies will be available to help people afford comprehensive insurance.

While some of these provisions benefit men as well as women, the federal government has made a genuine effort to ensure that women are in a better position as a result of health reform.

Edited by Alison Stanton

Add a Comment2 Comments

Glad you found it. We've all been trying to get the word out for a year. I guess we haven't succeeded yet. So we'll keep trying. It's actually a very good plan at a killer good price in many states. Jennifer

June 15, 2011 - 5:25am
EmpowHER Guest

Today we received our denial for health insurance due to a pre-existing condition. The requirements for a possible re-application are to be "symptom and treatment-free for 3-5 years." This is impossible.
Attached to the letter was a page discussing appeal rights, blah, blah, blah...and at the very bottom was a mention of PCIP and to check the website www.healthcare.gov for more information.
I skeptically went to the website and within minutes found that we might actually be able to buy semi-reasonably priced health insurance with fairly decent coverage and all our doctors are on the "in-network" list.
Up until today, I had no idea this program even existed and I do not live under a rock.
It is a shame that this program exists without any public education and awareness.
It reminds me of the Lead-Based paint law that went into effect April 2010 requiring all workers (and landlords and property managers) disturbing painted surfaces in pre-1978 homes, schools or child-care facilities to be EPA Lead-Safe Certified and pass an 8-hour training course to learn about lead-safe work practices. It's all posted on www.epa.gov/lead
I bet most people don't know about that either :-(

June 14, 2011 - 2:23am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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