1. What is the Patient Protection and Affordable Care Act (PPACA)?
The Patient Protection and Affordable Care Act is the health insurance reform legislation signed into law that requires health plans to cover preventive services at no cost. Preventive services that have strong scientific evidence of their health benefits, such as breastfeeding, must be covered and plans can no longer charge a patient a copayment, coinsurance or deductible for these services.
2. What are details on the Affordable Care Act rules pertaining to Preventive Services for Women?
Under the Affordable Care Act, women’s preventive healthcare services – such as mammograms, screenings for cervical cancer, and other services – are already covered with no cost-sharing for new health plans. On August 1, 2011, the Department of Health and Human Services (HHS) adopted additional Guidelines for Women’s Preventive Services that will be covered without cost-sharing in new health plans starting in August 2012. Coverage includes breastfeeding support, counseling and supplies, well-woman visits, contraception, and domestic violence screening. The guidelines were recommended by the Institute of Medicine (IOM)2 and based on scientific evidence.
3. When do breastfeeding services and supplies need to be covered?
If your insurance plan is affected by the Affordable Care Act, coverage is for health insurance plan years beginning on or after August 1, 2012. Your insurance provider is your source to confirm if your plan is affected.
4. Is this coverage subject to deductibles and co-pays?
No. Breastfeeding services and supplies must be covered with no cost-sharing (no copayments, co-insurance or deductibles) in plan years starting on or after August 1, 2012.
5. What lactation services and supplies are covered?
The provision states: “Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment”.
It is important to understand that each healthcare insurance plan will determine their specific lactation support and services, as well as breast pumps and supplies. Please consult your health plan provider to find out your coverage.
6. How does a health insurance plan deliver breastfeeding supplies to a member?
Each insurance plan independently determines their method of delivery of breastfeeding supplies. Your insurance plan provider is your primary resource for understanding the benefits of your policy and how to obtain your supplies.
7. Where can I access additional information?
Comprehensive information is available at the following government sites:
Please call the Warmline with any questions at 501-202-7378 or 1-888-BAPTIST and ask for the Warmline at extension 7378.
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