Since the Affordable Care Act became law in the year 2010, it has certainly improved women’s access to healthcare, as now they can find some best health insurance options depending upon their circumstances rather than just receiving the coverages that were approved based on their application. Before the Affordable Care Act, sex-specific health issues such as pregnancy, post-pregnancy care, sexual assault were a major hindrance in their path of obtaining affordable health insurance, if they have to enroll for non-workplace coverage. Around one-third of the women trying to buy an individual major medical insurance plan were either charged a higher premium or they were turned down because of their health or they had specific health conditions that were not covered under the plan.
The healthcare reform changed this fact and women were no longer charged more than men for the same health plan. As per the act they cannot be denied or charged more due to their health conditions. Besides, women now enjoy more options to obtain healthcare coverage due to the repeal of the ACA’s individual mandate penalty and due to the Medicaid expansion. In the last ten years, the number of uninsured women in the U.S. has reduced from 18% to 11%. Around 60% of women in the age group of 19 to 64 years obtain coverage through an employer-sponsored health plan, whereas 17% of women obtain coverage through Medicaid and 8% women obtain coverage through a direct purchase plan and 3% women obtain coverage through Medicare plan.
Some of the best Health insurance coverage options for women include:
ACA Plans – Individual major medical plans or ACA plans cover a range of benefits from hospitalization to preventive care services. Besides, these plans also include healthcare services within ten categories of essential health benefits such as pregnancy and childbirth. These benefits are specific to women’s health and these plans also include certain no-cost preventive care benefits. This means that enrollees cannot be charged a copay or coinsurance for these services, even if they haven’t reached their annual deductible. Some of the women-specific preventive services are as follows:
- Regular mammography screenings for women over 40 years to detect breast cancer
- Cervical cancer screening for women age between 21 to 65 years
- Well-women visit for women below 65 years of age
Based on these preventive services it can be said that the ACA plan meets most of the women’s healthcare needs during their early and later stages.
Is an ACA plan best for you?
While considering ACA plans option for them, women should look for subsidies such as premium tax credits that lower their monthly premium and cost-sharing reductions that lower their deductibles because these will make ACA plans an affordable health insurance option for them. Women qualify for ACA plans based on their income and should purchase these plans through a state-based or federal health insurance exchange. The ACA plans are best for women in the following cases:
- If they qualify for an ACA subsidy
- If they are not eligible for Medicaid
- If they are planning to become pregnant
- If they have health issues or having pre-existing conditions
During the open enrollment period or a special enrollment period, women can enroll in an ACA plan. On experiencing a qualifying life event women can enroll during a special enrollment period.
Short-term Plans – Short-term health plans provide temporary benefits to enrollees when they are in between individual or group major health plans. Though it doesn’t generally cover women’s health, with a new generation of plans launched into the marketplace this will certainly change. Women can now enroll in a short-term plan including the following non-standard benefits such as:
- 100% Immunizations
- Several preventive care visits
- A supplemental accident plan
However, women should keep in mind that short-term plans do not cover a wide range of women’s healthcare services covered under the ACA plans. Short-term plans are economical options designed to meet temporary healthcare needs ranging from 30 days to 364 days depending upon the state in which they live. With limited benefits and lower premiums, short-term plans do cover healthcare costs associated with unexpected illnesses and accidents. Short-term plans coverage varies but most of the plans include benefits like hospital stays, doctor appointments, surgery, and emergency room visits. Some plans may even include additional non-insurance benefits like telemedicine, dental and vision discounts, prescription drug discounts. Women need to pay close attention to pick the best short-term plan. Women can buy this plan all through the year upon approval of their application. The coverage starts as soon as the next day and the plan lasts 30 to 364 days depending upon their state of residence and personal need.
Short-term health plans are best for women in the following conditions:
- Short-term health insurance is best for women if they need to balance the cost-effective coverage with the unforeseen benefits. These plans are best for women who are in between major medical plans.
- Women who cannot afford ACA plan as they don’t qualify for a subsidy.
- Women who cannot obtain Medicaid.
- Women who missed open enrollment for ACA plans and don’t qualify for a special enrollment period.
Besides these some other life circumstances in which short-term plans may be an ideal option for women include:
- Waiting for job-based coverage to start
- Being in between jobs
- Retiring before Medicare-eligible age
- Self-employed women
- Employed in a job with no health coverage
- Turning 26 years of age
- Losing spouse coverage or going through a divorce
However, women should know that short-term health plans are not for everyone because these do not ensure guaranteed issue, which means that women can be denied coverage based on their health history. Women having pre-existing conditions many not qualify for these plans.