Enhancements to Women's Preventive Services

EmblemHealth has rolled out enhancements required by the federal health care reform law (the Affordable Care Act, or ACA), such as removing cost-sharing for many in-network preventive services.

This change, which began taking effect on September 23, 2010 for new and renewing individual and group health plans (except those with grandfathered status), allowed for visits to in-network providers for evidence-based preventive services, such as colonoscopies, blood pressure checks and childhood immunizations.

In addition to the list of preventive services offered in 2010, health plans must provide the following preventive services to women with no cost-sharing, beginning with plans issued or renewed on and after August 1, 2012*:

  • Well-woman visits
  • Gestational diabetes screening
  • HPV DNA testing
  • STI counseling
  • HIV screening and counseling
  • Oral contraception and contraceptive counseling
  • Breastfeeding support, supplies and counseling
  • Domestic violence screening

The new guidelines are based on recommendations by the Institute of Medicine, which was commissioned by the Health Resources and Services Administration to determine what preventive services are necessary for women’s well-being.

* The following plans are excluded from these enhancements: Medicare, Medicaid; NY Bridge Plan; grandfathered plans, such as the City of New York employee plan and certain Healthy New York and standardized HMO direct payment plans. Certain religious groups and churches may also be exempt from the contraceptives component of the preventive services mandate.

Learn more about the Affordable Care Act's enhancements to women's preventive pervices.