UC SHIP Expands Free Well-Woman Benefits in 2012-13
Free Federal Drug Administration (FDA)-approved contraception is available to UC SHIP members in 2012/13 as part of the Affordable Care Act’s (ACA) ruling for no-cost preventive care to curb the impact of serious and chronic disease.
The focus of this year’s reforms is an expansion of Women’s Preventive and Wellness Services, comprehensive preventive screening, immunizations, and other services attune to a woman’s health concerns throughout her lifespan. Most of these services are already covered under UC SHIP at no cost to members.
Beginning August 1, 2012, the Health and Human Services (HHS) ruled that a new set of no-cost preventive care services would be offered under health insurance plans based upon guidelines recommended by the Institute of Medicine (IOM). Removing cost barriers is a proven incentive for women to seek care. According to the HHS, a report by the Commonwealth Fund found that in 2009 more than half of women delayed or avoided necessary care because of cost—even a small copayment can be a barrier to care that could head off serious or chronic disease. Another study showed an increased number of women having mammograms when all cost sharing was removed.
As a university-sponsored self-funded student health plan, UC SHIP is not subject to Health Care Reform legislation; however, UC SHIP has complied with ACA health care reform voluntarily from the beginning, to fulfill the University’s mission that all UC students must have adequate health care protection and to provide a first-rate health plan to UC students that will remain viable as new legislation reform transforms health insurance in the years to come.
In 2011/12, among other measures, free preventive exams and cancer screening for men and women were provided to students at UC student health centers under UC SHIP, including preventive immunizations. Free well-child care for covered dependent children was made available through network primary care clinicians. UC SHIP does not limit coverage for pre-existing conditions and there are no waiting periods for care.
This year, free contraception and breast feeding support have been added to UC SHIP’s preventive care program, summarized below:
For students at student health centers or Anthem network providers (referral required) & dependents at Anthem network provider:
FDA-approved prescription contraceptive drug coverage
• $0 copayment for generic contraceptive drugs
• $0 copayment for brand name contraceptive drugs when there is no generic equivalent
FDA-approved contraceptive devices & procedures
The following prescribed contraceptive devices and services are provided to women at student health services or by an Anthem network provider (referral required) with no patient copayment, coinsurance, or deductible:
• Diaphragms provided and fitted in a doctor’s office
• Diaphragms prescribed by a doctor and provided at a pharmacy
• IUDs inserted in a doctor’s office
• Implantable contraceptive drugs administered in a doctor’s office
• Female sterilization performed in the hospital or as an outpatient procedure and not related to any other medical procedure, such as maternity delivery. Pre-certification for a hospital admission is required if the procedure takes place in a hospital.
Breast feeding support, supplies, and education
Breast pumps obtained from an Anthem network Durable Medical Equipment supplier are covered with no patient copayment, coinsurance, or deductible.
Tuberculosis screening was identified by UC SHIP’s governing panel as an additional important service to offer students. This year, free Tuberculosis screening is now available at all UC student health centers.
To find out more about health care reform and the Women’s Preventive Services expansion, visit the following website:
Guidelines for Women’s Preventive Services: http://www.hrsa.gov/womensguidelines/