Women’s Health Insurance Guide 2022
health insurance for women
For women in the United States, access to affordable coverage in the personal health insurance market has improved significantly over the past decade, in large part due to coverage improvements and consumer protections provided by the Affordable Care Act.
Before the introduction of the ACA – mostly from 2014 onwards – women faced many obstacles when mating:
- To date, more than half of the individual tariffs for a 40-year-old non-smoker demanded higher premiums than for a 40-year-old smoker – with exactly the same coverage.
- More than 90% of individual health plans did not provide routine maternity benefits.
- In all but five states, pregnancy was a pre-existing medical condition that prevented a woman from purchasing individual health insurance.
- Many individual health insurance companies did not offer contraceptive protection.
- Coverage of women’s welfare varied greatly from state to state.
We hope you use this guide to better understand how coverage has improved — and what to expect when choosing a health insurance plan for women’s health care coverage.
Provision for women according to the Court of Auditors
Prior to the implementation of the Affordable Care Act, the amount of preventive care provided to women varied widely from state to state. But from August 2012, all health insurance companies (with the exception of existing health insurance companies) had to cover certain women-specific categories of pension benefits:
- Well attended mrs
- gestational diabetes screening
- HPV test
- Domestic violence screening and counseling
- HIV testing and counseling for sexually transmitted infections
- breastfeeding accessories
- Advice on contraception and family planning
(Note that additional advance directives went into effect in 2014, including provisions for children and all adults, and additional provisions specific to women.)
Coverage of women’s health services
Maternity care coverage
Prior to 2014, only 12% of individual health insurance plans included maternity benefits. But the Affordable Care Act changed the game. Maternity care is one of the essential health benefits that must be included in all individual and small group insurance policies.
This means that an expectant parent can now receive coverage in any state during open enrollment or during a special enrollment period triggered by a qualifying event. And women no longer pay higher premiums than men, even though every new major medical plan includes maternity insurance.
Coverage of infertility treatments
Infertility treatment is not a core benefit of the Affordable Care Act – and coverage for infertility treatment is not required by the ACA or any other federal law. However, some federal states have regulations that go beyond the minimum requirements set by the federal government with their own laws, ordinances and mandates.
These state rules apply only to state-regulated plans, which include health plans that individuals and businesses purchase from an insurance company. But self-insured employer-sponsored health plans are not subject to state insurance rules.
Abortion insurance is neither required nor prohibited under the ACA. But federal funds can’t be used to pay for abortions unless the situation involves rape, incest, or danger to the life of the mother. Coverage for other abortions varies significantly from one health plan to another.
The Affordable Care Act increased access to highly effective long-term birth control without a cost barrier. Under the ACA, healthcare guidelines effective on or after August 1, 2012 must cover at least one version of each FDA-approved female contraceptive method, without cost sharing. These include sterilizations, IUDs, and implants, which before the ACA often had significant upfront costs.
Access to health services for women has been greatly expanded under the ACA. This was not only due to the cover orders of the Court of Auditors (e.g. provision and maternity leave), but also because the Court of Auditors has led to many more women being health insured. The expansion of Medicaid, the employer mandate, and access to subsidized coverage in the health insurance exchange/marketplace have all played a role.
But women’s health and care continue to be contentious issues, and the rules evolve over time.