Healthcare Reform Update - Birth Control Must Be Covered In Full

On August 1, 2011, the Department of Health and Human Services released an amendment to the Interim Final Regulations for preventive care under the Patient Protection and Affordable Care Act (PPACA). The amendment applies to non-grandfathered individual insurance policies as well as non-grandfathered insured and self-insured group health plans.

The amendment provides additional guidelines for women’s preventive services. Health plans will need to cover women’s preventive services, including birth control, without copayments or deductibles. The guidelines reflect the recommendations made last month by the independent Institute of Medicine.

For plan years beginning on or after August 1, 2012, non-grandfathered plans will be required to cover the following additional preventive care services for women with no cost sharing:

  • Annual well-woman visits
  • Screening for gestational diabetes
  • HPV DNA testing for women 30 years and older
  • Sexually-transmitted infection counseling
  • HIV screening and counseling
  • FDA-approved contraception methods and contraceptive counseling
  • Breastfeeding support, supplies, and counseling
  • Domestic violence screening and counseling

See these links for more information:

Please note that plans may impose cost sharing on brand name preventive drugs if a generic version is available and is just as effective and safe for the patient to use. Cost sharing would not be permitted on the generic drug.

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