New Guidelines for Women's Preventive Healthcare 8/1/12

As part of the Affordable Care Act, the Department of Health & Human Services (HHS) has adopted new guidelines for women’s preventive services that will be covered at 100% (and not subject to the deductible).  These changes go into effect for non-grandfathered plans when your plan renews on or after August 1, 2012.

Health Resources and Services Administration Supported Women's Preventive Services: Required Health Plan Coverage Guidelines

Type of Preventive Service

HHS Guideline for Health Insurance Coverage


Well-woman visits.

Well-woman preventive care visit annually for adult women to obtain the recommended preventive services that are age and developmentally appropriate, including preconception and prenatal care. This well-woman visit should, where appropriate,  include other preventive services listed in this set of guidelines, as well as others referenced in section 2713.

Annual, although HHS recognizes that several visits may be needed to obtain all necessary recommended preventive services, depending on a woman’s health status, health needs, and other risk factors.* (see note)

Screening for gestational diabetes.

Screening for gestational diabetes.

In pregnant women between 24 and 28 weeks of gestation and at the first prenatal visit for pregnant women identified to be at high risk for diabetes.  

Human papillomavirus testing.

High-risk human papillomavirus DNA testing in women with normal cytology results.

Screening should begin at 30 years of age and should occur no more frequently than every 3 years.

Counseling for sexually transmitted infections.

Counseling on sexually transmitted infections for all sexually active women.


Counseling and screening for human immune-deficiency virus.

Counseling and screening for human immune-deficiency virus infection for all sexually active women.


Contraceptive methods and counseling. ** (see note)

All Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.

As prescribed.

Breastfeeding support, supplies, and counseling.

Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.

In conjunction with each birth.

Screening and counseling for interpersonal and domestic violence.

Screening and counseling for interpersonal and domestic violence.


* Refer to recommendations listed in the July 2011 IOM report entitled Clinical Preventive Services for Women: Closing the Gaps concerning individual preventive services that may be obtained during a well-woman preventive service visit.

** Group health plans sponsored by certain religious employers, and group health insurance coverage in connection with such plans, are exempt from the requirement to cover contraceptive services.  A religious employer is one that:  (1) has the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a non-profit organization under Internal Revenue Code section 6033(a)(1) and section 6033(a)(3)(A)(i) or (iii).  45 C.F.R. §147.130(a)(1)(iv)(B). See the Federal Register Notice: Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under the Patient Protection and Affordable Care Act (PDF - 201 KB)


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