Women’s health insurance coverage, along with many other women’s issues, can be very complicated. There is good news and there is bad news. Women are lucky because, according to the actuaries at insurance companies, we live longer. Many women may survive their spouses, and many of us could live a long life, but if we don’t take care of ourselves, that life may be in a very unhealthy state.
With some preventative treatment and annual exams, many women’s health problems can be caught before they become serious and lead to large medical bills and debt. I want to encourage all women to discuss with their doctors what changes need to be made in order to have a happier and healthier life expectancy that will minimize healthcare costs.
Health insurance coverage and a woman’s annual exam
If you have health insurance, check with your plan summary to see if your plan allows for a “free” or no co-pay annual exam with your OB/GYN. This encourages women to visit the doctor to check for health issues before they become serious medical problems. I don’t mind saying that an annual exam is absolutely fundamental. A mammogram typically doesn’t carry a co-pay either, so ask your doctor when you should start including one with your annual exam.
Prescription coverage for birth control
Prescription coverage for your health insurance plan can be complicated. There is typically a deductible that goes along with a three-tier benefit plan. With thousands of birth control options available, the most efficient way to check your prescription drug coverage benefit is to see how the options your doctor is prescribing are classified with your insurance carrier. You can contact the carrier or your insurance agent to determine the co-pay costs to you.
Be aware that there are usually different co-pays for generic prescriptions, preferred medications, and formulary medications. This can be more confusing than it needs to be, so I recommend you discuss your prescription options with your doctor. I also recommend you always ask if there is a generic option available.
Medical history and your premium
Some states underwrite your health insurance plan based on your age, gender and health history, while others, including New York, are considered “community rating states” and do not. If you reside in an “underwritten state,” your premium could change at each renewal, based on your current health situation and medical history. However, even those living in community rating states may be subject to prohibitive and exorbitant annual premium increases.
What if you don’t have health insurance coverage?
Open door clinics or open door community health centers help people in need of medical care who do not have adequate health insurance coverage. Organizations like Planned Parenthood also offer health care to women on a sliding income scale. To find a clinic near you, do an Internet search for Planned Parenthood or the Department of Health and Human Services.
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