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Preventive services for women further defined

added Aug. 25, 2011

On Aug. 1, 2011, the U.S. Department of Health and Human Services adopted additional Guidelines for Women’s Preventive Services – including well-woman visits, support for breastfeeding equipment, contraception and domestic violence screening – that will be covered without cost sharing (deductible, copays or co-insurance) in non-grandfathered health plans with plan years beginning on or after Aug. 1, 2012. The guidelines were recommended by the independent Institute of Medicine (IOM).

The additional preventive services for women that will be covered without cost sharing by non-grandfathered health plans include:

For more details, please visit: www.hrsa.gov/womensguidelines.

The rules governing coverage of preventive services that allow health plans to use reasonable medical management to help define the nature of the covered service also apply to these women’s preventive services. Health plans will retain the flexibility to control costs and promote efficient delivery of care by, for example, continuing to charge cost-sharing for branded drugs if a generic version is available and is just as effective and safe for the patient to use.

For more details, see the information in our FAQs section.