Local Planned Parenthood heralds August 1st roll out of new insurance benefits

Agency advises patients to call their insurance plan member services office for specifics

On Aug. 1, 2012 a new phase of the Affordable Care Act will take effect, requiring new insurance plans to cover a host of women's preventive health care services, including birth control with no co-pays or deductibles. As the leading local provider of women's health care, Upper Hudson Planned Parenthood (UHPP) knows firsthand how critical these benefits are for women and families.

About 25% of the patients who come to UHPP have private insurance. These patients must often be charged a co-pay of $25 to $30 for an annual visit plus an average of $25 to $30 co-pay per month for a birth control method. New York State had already eliminated co-pays for family planning patients who qualify for Medicaid or who pay out of pocket on a sliding fee scale based on income. Now, women with insurance will also be able to obtain critical preventive services without fees.

"We see the need for affordable health care every day, and we are thrilled that health care reform will begin to make essential women's health care services increasingly accessible and affordable for many women," said Patricia McGeown, UHPP President and CEO. "Patients who come into our health centers often struggle to balance paying for birth control and health services with paying for textbooks, groceries, child-care or gas for the car. Health care reform changes that and will make those decisions easier for women."

McGeown explained that the roll out of these important benefits begins on the first of August for some people with private health insurance. However, more consumers will start getting the benefit next year, she said.

The Affordable Care Act requires insurance companies to provide the benefits for new plans beginning on "plan years" that start after Aug. 1. Insurance companies have different plan years. Some start Aug. 1; most start Jan. 1, and some start June 1.

Under the law, new private insurance plans are required to cover basic preventive care without any out-of-pocket cost, including birth control, cancer screenings, well-woman visits, counseling for sexually transmitted diseases, breastfeeding support and supplies and domestic violence counseling.

McGeown stressed that women should call their insurance companies to determine if their plan is impacted by these changes and, if so, when the benefits become effective for them and what limits, if any, there may be. She noted that the law allows insurance plans to limit birth control coverage with no co-pays to generics.

In the last few decades, U.S. health care costs rose steadily while health outcomes declined. As the economy declined, more and more individuals and families lost health care coverage. The Affordable Care Act, passed by Congress and signed into law by President Obama in 2010, was a compromise between those who have radically different ideas about how to approach these issues. But the compromise was reached and the nation must move forward.

The Affordable Care Act has already resulted in concrete and significant health benefits for many Americans, and particularly for women and young adults. More benefits are scheduled to take effect over the next couple of years. Ultimately, under this approach, millions of Americans will have access to basic preventive care at no personal cost.

Now is the time to focus on the promise of health care reform; for establishing user friendly health care exchanges and a clear range of plan options to meet the needs of individuals and families; for establishing incentives and payment systems that ensure the availability of primary care and family planning providers; for expanding access to Medicaid for women and families who need it most; and finally for planning and funding an all-out effort to assist Americans in selecting and using a health care plan for early, preventive health care services. If these actions are made the priority, we will have a healthier nation and a more efficient and less expensive health care system.

UHPP has been serving patients with private insurance for 78 years. "Our centers and the nearly 800 Planned Parenthood health centers nationwide will be here for newly insured women who want quality health care from a provider they can trust," McGeown concluded.