Did you know that a “well-woman” visit is now fully covered by insurance under new law? Yes, all teen girls and women up to age 65 are recommended to schedule a well-woman visit once a year. And that has just been made easier thanks to the Affordable Care Act.
A well-woman exam is important for tracking your overall health and taking care of your body’s needs as they change over time.
Here’s a summary of must-know information about the well-woman visit:
- It’s preventative care done by your primary care provider. It consists of a full-check up, screening and tests, and counseling to help you make informed choices.
- Well-women visits are different from Pap smears. The Pap is recommended every three years for 20-29 year olds and are usually done by a gynecologist.
- You don’t have to pay. Because well-women visits are classified as “preventative care”, your insurance must cover it by law, including separate visits such as a mammogram, scheduled by your doctor during the wellness exam.
- You and your primary provider decide what happens at the appointment. Go to healthcare.gov for a full list of what is covered under a well-woman exam.
This post by Chelsey Delaney was originally published on Bedsider.org.
BY BEDSIDER | Besider.org
UPDATE: Open enrollment for 2016 health coverage goes from now (November 2015) until January 31, 2016. Keep in mind, if you want coverage starting on January 1, you’ll have to pay your premium by December 15. Explore your options at HealthCare.gov!
If someone asked me a month ago what a “well-woman visit” is, I would have posited that it’s the magical time of year when you visit your gynecologist and he or she pokes around in your vagina. (Then I would have followed with the story of the time my gynecologist joked that she couldn’t find my cervix and that it probably fell out somewhere. Gullible was written all over my uterus that day.)
Unfortunately, my explanation wouldn’t have been completely accurate. In fact, for many women the poking I’m referring to—the Pap smear—isn’t required annually. For a woman like me, in the age range of 21 to 29, Paps are recommended every three years as long as there are no other factors that make more frequent Paps necessary. Also, you don’t have to see a gynecologist for a well-woman visit—you can see your primary care doctor, nurse practitioner, etc.
So, what is a well-woman visit? Well, woman, it depends. Here are six basics you should know:
1. It’s all about preventive health.
Prevention and planning, yo. Going to the doctor only when you’re sick is so last-century. As you age, your body changes and will experience new challenges. A well-woman visit is there for you to understand your own personal health risks and how to readily avoid them.
2. It’s just like a physical, only it doesn’t have to be as…physical.
Don’t just get tests—ask questions. What’s on your mind? Talk about your stress levels, your nutrition, your mood, your medications, your sex life, your family’s health history—next to nothing is off the table. Asking questions and raising concerns helps your health care provider know what’s important to you and what he or she should screen you for. Speaking of health care providers…
3. A good relationship with your provider is vital.
More than ever, health care is beginning to embrace the idea that hey, maybe providers and patients should get along and have open dialogues about stuff. Your provider should meet you in the middle and show a genuine interest in your health—no judgments. Allowing yourself to build trust into that relationship will increase the likelihood of a satisfactory visit (and you’ll also feel less awkward when you need a pelvic exam).
4. It’s not always one-and-done.
While the well-woman visit is often talked about as a single, annual visit, it doesn’t always stop there. For example, if you’ve got a history of breast cancer in your family, your provider might decide that you should get a mammogram. If the mammogram is scheduled at a different time and place, this should also be covered by your insurance. Same deal if you decide to get an IUD or implant—if you need to make a separate appointment for insertion, that should be covered too. Why is this important to know? Because…
5. You shouldn’t be charged for certain preventive services, including well-woman visits.
Don’t touch that wallet if you have health insurance and your provider is covered under your plan. Under the Affordable Care Act, preventive services should be covered by insurance with no out-of-pocket costs. Tip: Be sure to say you’re coming in for a “well-woman visit” when you schedule your appointment(s). And, while it may be tempting to tack your visit onto a sickish-visit with your provider, try to avoid it just to make sure the billing doesn’t get complicated.
6. The contents of your well-woman visit are up to you and your provider.
As far as services go, your visit(s) could include any/some of the following depending on your current health status:
- Contraceptive counseling
- Alcohol misuse screening
- Blood pressure screening
- Cholesterol screening
- Depression screening
- Nutrition and diet counseling
- HIV screening
- Vaccines and immunizations
- STI screening
Check out healthcare.gov for a full list of services that are covered under the well-woman visit label. And if your insurance isn’t paying for services you think should be covered under the Affordable Care Act, contact the National Women’s Law Center’s hotline 1-866-745-5487 or via email at CoverHer@nwlc.org to let them know what’s going on and see if they can help.
You’re entitled to a well-woman visit every year until you’re 65. It’s not that you should stop being a well woman when you’re 65, it’s just that when you’re 65 you’ll have Medicare, and Medicare rules. Hopefully, it will act as a reward for being so well for so long!
BEDSIDER is an online birth control support network for women operated by The National Campaign to Prevent Teen & Unplanned Pregnancy. Bedsider is totally independent (no pharmaceutical or government involvement). Honest and unbiased, Bedsider’s goal is to help women find the method of birth control that’s right for them and learn how to use it consistently and effectively, and that’s it.
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