For working women, healthcare merits extra consideration when it comes to choosing their health insurance. With a longer life expectancy, women use different and more types of medical services than men.
While many households balance the care of the family, the stress of coordinating family care and increasing premiums take a toll on women’s health, and they are will deal with inconsistent insurance coverage more often than males.
Coverage Improves Slowly in the United States for Women
With the 2010 Affordable Care Act (ACA), many preventative measures became covered without the need for a copayment, such as gestational diabetes screening, mammograms, HPV testing, breastfeeding services and support, domestic violence counseling, certain FDA-approved contraceptives and “well-woman” annual checkups.
With shifting government policies, risks for breast cancer and autoimmune disease and maternity concerns, women should know what their health insurance covers and what to look for when shopping for a new policy. As of 2016, a federal judge issued a final rule prohibiting discrimination based on sex, including pregnancy and gender identity, known as the “Nondiscrimination in Health Programs and Activities” rule as part of the ACA, and for now the ACA stays law. Women are protected under their healthcare coverage and services from discrimination.
Yet, the United States still has a long way to go when it comes to providing maternity leave equal to more forgiving policies overseas. The United States currently provides up to twelve weeks of unpaid leave under the Family and Medical Leave Act (FMLA), with job protection up to one year. A new mother may take leave before or after the baby arrives. Some paid leave policies are available under certain employers, such as Facebook and Twitter. Check with your company regarding their leave policy, which may be more generous than assumed.
Know What Your Health Care Plan Covers
Much has improved for healthcare for women in the workplace. Making a choice for a health plan is never easy, especially when life and health status may change at any time.
If you already have a health plan under your employer, it’s important to know what is covered, what your deductible is and how much your co-pay is, depending on the type of visit. It never hurts to give the insurance provider a call to go over any areas of confusion. Here are a few questions to ponder when reviewing your policy or shopping for another one:
- What kind of plan is this? For indemnity plans, you’re usually able to choose your own doctors, with both the plan and you paying a percentage of the cost.
For a preferred provider organization (PPO) or health maintenance organization (HMO), your out-of-pocket costs are typically minimal. For HMO, your employer or you pay a fixed fee monthly for services, but you have to go through the provider’s HMO network. A PPO plan offers flexibility at a cost, with a discount offered inside the PPO network and paying more to go outside of it.
- What health screenings does my insurance cover? It should cover mammograms, cervical cancer screenings, pap smears and osteoporosis screenings. For women over 40, one annual mammogram has been required in the past. Be sure that regular check ups and immunization are also covered.
- For diseases common to women, what treatments are covered? This should go over items such as osteoporosis and cervical or breast cancer.
In certain cases, the insurance will also cover plastic or reconstructive surgery, especially when it comes to breast surgery. Health insurance is required by law to cover breast reconstruction cost after a mastectomy due to cancer (ADD) or a genetic disposition. The Women’s Health and Cancer Rights Act (WHCRA) protects women who suffer from breast cancer and choose to have reconstructive surgery after breast removal.
- Does my plan cover all prescription drugs, including contraceptives?
- What aspects of pregnancy are covered under the plan? Most hospital visits and check ups are covered when you’ve conceived, but check for red tape if you conceived before you got your health insurance.
- What about treatment for infertility? Is this covered and to what degree?
Women have different healthcare needs than men, and in the past, have faced discrimination by employers and health insurance providers for those different needs. Fortunately, government policies and companies are stepping up to fill the health coverage gap.
When choosing a policy, it’s important to think of treatments and screenings you may need over the course of your life. Ask yourself: What does my health plan cover. Take into consideration common diseases that affect women and your family. Look closely at the benefits and doctors you’d be seeing to know if your health plan is right for you.