• Health Care Reform

    Under health care reform, additional women’s preventive services now fully covered


    September 17, 2012

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    The Patient Protection and Affordable Care Act has provided U.S. citizens with many benefits. The newest provision adds more preventive care for women, many of which were already covered by Blue Cross and Blue Care Network.

    Some of the services covered for women won’t cost Blues members a penny out of pocket when services are rendered by network providers and certain other conditions are met. The services  include:

    • Annual well-woman and OB/GYN visits
    • Annual counseling for sexually transmitted diseases
    • Annual screening and counseling for HIV
    • One human papillomavirus (HPV) test every three years for women age 30 and up
    • Two gestational diabetes screenings for  women during pregnancy
    • Breastfeeding counseling and support, including one breast pump following delivery (no more than one pump every 24 months)
    • Contraceptive counseling and coverage to include all FDA-approved generic contraceptive methods, as well as some emergency or “morning after” generic contraceptives. Note that:
      •  Over-the-counter contraceptives, like foams and condoms, won’t be covered.
      • Male contraceptives won’t be covered.
      • A new “Limited Rx” benefit card is being mailed to all subscribers who didn’t previously have a prescription drug plan through BCBSM, Blue Care Network or another pharmacy benefit manager. That card can be used for generic female contraceptives.

    These new benefits fit right in with the Blues’ focus on preventive care. In fact, we already provide coverage for many of the services mandated by the health care reform. That’s because prevention is the foundation of the care we provide. We believe that preventive care can help keep you healthy and avoid serious and expensive medical conditions.

    Because of how they’re structured, certain BCBSM and BCN plans don’t include these services.

    In addition, some group health plans sponsored by certain religious employers may also be exempt from having to cover contraceptive services. However, they must cover all other preventive services.

    When do these changes take effect? Those with individual coverage from the Blues received this benefit update on Aug. 1. The changes go into effect for members of group plans that begin on or after the same date. Most Blues group members who have 2013 effective dates will see the changes Jan. 1, 2013.

    For more specific information about these new benefits, contact your health plan administrator, or call the customer service number on the back of your BCBSM or BCN card. For the latest information on health care reform, visit bcbsm.com/healthreform.

    Photo by Big Grey Mare

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