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Expanded preventive services for women and other individual plan updatesOctober 9, 2012
We will be mailing a letter to New Hampshire members in mid-November about important plan updates. Some members will receive information explaining the new preventive services for women. Other members who have already received a women's preventive notification will only have a revised contract and endorsement updates in their member letter.
As required by the Affordable Care Act, also known as federal health care reform, all existing members will receive expanded preventive coverage for women on January 1, 2013 (with one exception noted below). The following services, drugs and supplies received from network providers will be paid at 100%:
Expanded Coverage for Women
- Well woman visits.
- Breastfeeding support, supplies and counseling including one breast pump per pregnancy purchased from a network medical provider.
- Prescription contraceptives (birth control) and counseling for women. The drug plan formulary determines which specific drugs are covered under the plan. To get 100% coverage for a covered prescription contraceptive, it must be a generic drug or a brand-name drug that doesn’t have a generic equivalent and be obtained from a network pharmacy. A cost-share (such as a copay, coinsurance or deductible) may apply for other prescription contraceptives, based on the plan’s drug benefits.
- Permanent surgical contraception (sterilization).
- Counseling for sexually transmitted infections.
- Counseling and screening for Human Immunodeficiency Virus (HIV).
- Counseling and screening for interpersonal and domestic violence.
- Screening for gestational diabetes.
- Testing for Human Papillomavirus (HPV).
Members on non-grandfathered plans will receive all of the benefits listed above. Members on grandfathered plans will also receive all of the benefits listed above except prescription contraceptives (birth control) and counseling for women. These changes will be effective January 1, 2013.
Details regarding the expanded women’s preventive coverage and other plan updates will begin mailing to members around November 11, 2012.
If you have questions, please contact your Individual Regional Sales Manager or Individual Broker Sales Representative.