Open for Questions with HHS and WebMD: Women's Preventive Services

Uploaded by HealthCareGov on 01.08.2012

>> Hello and welcome to our live chat on women's health and the preventative services available
to women under the healthcare reform law. I'm Annic Jobin from WebMD, happy to be joined
by secretary of health and human services Kathleen Sebelius.
Thank you for joining us.
>> Glad to be with you. Our goal today is the answer as many of your
questions as possible as the new services covered by health plans starting on or after
August 1st, effective when your plan renews or if you get a new plan.
We reach lot of women at WebMD, of the 107 million people that we serve each month the
majority are women. And many of you are the family managers.
And the caregivers for children. Spouses, aging parents.
Which leaves very little time for your own house.
So today, it important to talk about your health and the services available to you.
So before we discuss the new preventive care that will be available let's take a moment
to remind everyone about some of the key services for women that are already covered under the
affordable care act with no extra costs to you.
By no extra costs no co-pays, co-insurance or deductibles for those service.
Secretary Sebelius, I bring this up because we got a lot of questions about what about
my mammograms and what about screenings for cervical cancer?
Those services are already covered under the healthcare reform law, correct in
>> That's right. ANNIC.
Part of the goal of the health law is to keep people healthy in the first place and not
wait until people neat to go to the hospital or have acute medical condition so getting
preventive care is really a shift. And a shift without co-pays deductibles, co-insurance,
to put down financial barriers that might be in the way of someone getting prevention
they need. So starting as far back as September of 2010,
six months after the new law went into effect, a whole host of prevention services for men
and women and children went into effect without co-pays and deductibles.
Recommended cancer screenings, flu shots, children's immunizations.
Again, available and updated by the U.S. preventive services task force, a group of medical providers
who each and every year look at the evidence and make new recommendations based on the
newest science. When their recommendation is an A or B recommendation,
those automatically get added to the list of preventive services available to men and
women who then add them to your insurance policy without co-pays or deductibles.
The second set of prevention services came into effect in January of 2011 for Medicare
beneficiaries. The majority of beneficiaries are women.
Women over of 5 as we're older women become a larger group of Medicare beneficiaries because
we often outlive our spouses and colleagues but Medicare has a range of prevention services,
cancer screenings, a well woman visit, other issues provided to the Medicare policies without
co-pays and without co-insurance. Big step forward.
So this is actually kind of the third step of the process.
>> Great. Now that we have covered the health services
in place, let's talk eight new prevention services starting with the well women visits.
We received a question from a woman named Beth who wanted to know what exactly is included
in the well woman visit? She asked does it include a physical exam?
>> Sure. It's really a checkup.
You're going the see your doctor because not because you're sick or have an episode or
need a treatment but because you're getting a checkup.
Typically that's not covered without a co-pay or co-insurance.
We think it makes good sense for people to get checked on a regular basis.
So absolutely includes a physical exam and it's an opportunity for a woman to have a
conversation, with a healthcare provider, when she isn't in some kind of serious situation.
How to stay healthier. Maybe she wants to look at weigh issues or
maybe having trouble exercising having some problems that maybe appropriate to her and
women as you said earlier, often don't take enough time for ourselves, we're taking care
of kids, looking out for parents, urging our spouse to go, get checked out but we come
last. So this is really an opportunity say this
is a good idea. Once a year go and see your own physician
and have a conversation about your health.
>> Contraception. Contraceptive counseling.
A popular topic. I should add here in addition to getting questions
from web M.D. we reached out to Netscape our network for healthcare professionals to find
out from them what are the questions that they hear the most often from female patients?
One question they heard over and over again whether nurses doctors or pharmacists has
to do with inadequate coverage for birth control. Even among women who have coverage.
One OBGYN in Florida told us his patients are eager to use long term birth control methods
like IUDs, birth come implants but the patients complain it's not covered under the health
plans so the question is what exactly will be covered now when it comes to contraception
in >> As we like to say today is new day for
women's health. All the FDA improve contraceptive methods
including long term IUDs and plantation methods will be covered under this plan, no co-pay,
no deductible. We know contraception is the most frequently
taken prescription drug for women 14 to 44, women take it not only to make family planning
decisions but also it's used for a variety of other medical conditions.
And as you say, lots of times people rather look at longer lasting method than once a
day pill, methodology and those range of services will be covered so having a conversation with
your healthcare provider, figuring out what's best for you in your situation, your age,
interest in what kind of decision you're trying to make, short term or long term.
That will now be a covered service, many plans in the private market didn't cover contraception
at all. So women were paying 100% out of the pocket,
even if you as you say the choices are unlimited and high co-pays attached to it.
So lots of women were in a very difficult situation.
This has got a lot of attention because there are some employers who have religious objections
to offering contraceptive coverage. And there are two pieces of this puzzle, first
of all, if you work directly for a church or a church August sill layer -- auxiliary
those entities are exempt from coverage. Secondly religious employer who has religious
objectives like Catholic hospital or university, we are in the process of developing a method
so that the contraception will be provided to those employees.
One additional year how to wait additional year.
But the employers won't purchase or refer peep oral pay for the contraception.
Or third party administrator. So make sure women have act that health benefit
and make their own decisions whether or not to use contraception.
But at the same time respect religious objections and employer and figuring out a strategy for
what is a relatively small number of women but important group who need to make their
own choices about their own family planning issues.
>> How young or old does a woman have to be to have contraception or counseling?
Is there a minimum age?
>> It depends on a family plan coverage but if a woman is in a situation where a provider
is recommending a family planning method the insurance policy would cover it.
>> A related topic also popular was screening about counseling for sexually transmitted
infections. One web M.D. user asked how often STD screening
is allowed or covered.
>> Well, my understanding is the method may change depending on recommendation of physician
but at least once a year the screening will be covered as part of the program.
That could vary from person to person if they're a reason for a more frequent screening but
what we know we finished a major conference in Washington around HIV and AIDS.
In addition to STDs screened for and counseled this also includes HIV screening.
Women are unfortunately a growing percentage of the population of new infection so what
we heard over and over again at the conference last week is that often healthcare providers
just overlook the fact that some illness presenting itself maybe related to HIV this is an important
issue not to just have cover bud remind provider it's an important screening for women to get.
>> There's another service that you might get to mention here is HPV DNA testing for
women. Now, I think that's only available for women
or adding to women 30 and older. Question why 30 and older?
>> Because the preventive services task force is already covering the basic screening which
is related to cervical cancer. So this is really an additional DNA test for
slightly older population to make sure that that testing is complete and that we actually
again look at determination of whether or not the woman is more likely to be cervical
cancer, a victim in the future and catch it early.
Begin to treat early.
>> That's the key. Catching it early.
Let's move to services for women who are pregnant. Plans are not going to cover screening for
gestational diabetes. Can you help explain specific tests and points
in the pregnancy or should all women who are pregnant look to get screening done?
>> I think it is highly recommended screening to do because gestational diabetes is not
only dangerous, for mother and potentially infant but is often presence itself in women
who have no symptoms diabetic condition prior to pregnancy, it is a condition that is brought
on by pregnancy. So having consultations with OBGYN, getting
regular pre-natal care recommended for all pregnant women but making sure again this
issue which can be life threatening is look for along the way an important piece of puzzle
and will not cost additional money, will not take additional out of pocket costs for family
who maybe trying to save every dime to get ready for the babies arrival, often they think
we might need to do that extra test, this is an important extra test to do.
>> We also heard from expecting moms who wanted to know how the breast feeding services will
work. One woman asked will insurance provide a list
of lactation counselors or other providers are covered under my insurance and what about
breast bumps are those covered? And how far reaching is the provision for
breast feed something >> I know that there are lots of lactation
counselors. And often connected to a pre-natal visit in
classes and my daughter-in-law is pregnant right now and she was -- very excited.
It's all about being a grandma, you know. It seems like a good deal to me.
But she has just finished lactation classes. That was part of her pre-natal care so I'm
not exactly sure, I think this may vary from place to place, how broadly the counseling
will be covered. I know it does cover counseling and whether
directly related to your OBGYN practice or can be a broader group.
But I know also the insurance policies will now pay for breast pumps and counseling services.
So some moms need additional help. The baby may not take to nursing right away
but what we know is how valuable it is to not only an emotional bonding experience between
mother and child but long term health benefits. The baby bills up enormous immunities to all
kinds of situations if he or she has breast milk for at least a couple of months.
So having -- taking some time, having consultation helping working mom with some supplies has
long term health benefits for that infant and long term for both mother and child.
This again, people look and say how does that get to be a preventive service.
It's preventing a lot of childhood illnesses that we know are less frequent in baby whose
start their life with breast milk than start any other way.
>> Domestic violence screening. If we have any women watching today that are
suffering from abuse, whether it be physical or mental, where can they go for help?
What type of counseling is available to them?
>> This is an issue which often is off the radar screen, a lot of women, I used to work
with domestic violence victims and it's an unfortunate equal opportunity victims races
ethnic background, income levels are one point or another victims of domestic violence and
people often Neal ashamed or feel they have done something to cause the violence to occur.
So just as a practical matter, reaching out to someone that you feel safe with, a friend,
a neighbor, certainly if you have a doctor reaching out to a healthcare provider.
In every community in this country there are shelters and safe houses that women and children
can go to and be safe and secure and many states now have mandatory arrest programs
so there's no protection around a domestic violence victim.
This is an insurance situation it is illegal to deny health coverage to a victim because
she was a domestic violence victim. That's considered a pre-existing health condition,
that will no longer be legal by 2014, it will become a thing of the past.
This is also a way to make sure when you visit a healthcare provide their you can get some
additional help and support because domestic violence victim may need mental health service
which is are available as part of insurance plans, may need some additional physical attention
or issues which wouldn't be immediately apparent but part of woman's health situation and might
need some advice about how to get into a safe situation and stay in a safe situation so
all that is part of what's covered in the new policies.
>> I know with so many women struggling to afford health insurance we received a lot
of questions about what are the options if I don't have coverage.
Rachel shared following question. She said I work but I have no insurance through
my job and I can't afford it. How would this affect me?
>> Right now for Rachel, if she has a serious pre-existing health condition and she has
been denied coverage because of her health issues, which happens to women all the time
in the market, there are now pre-existing pools in every state and the coverage is just
too expensive to buy on her own short term there aren’t a lot of good options but starting
January 2014 Rachel will have number of options, she may qualify for medicaid and that program
will open up and be available. In every state there will be a state operated
exchange for people who are working but dent make enough money to buy their coverage 100%
on their own. Tax credits which amounts to up to $4,000
per family to come into the insurance market. Insurance will be available without pre-existing
conditions and great news for women, it will be illegal starting in 2014 to charge women
more than men. Right now companies can totally legally charge
a woman 50% more for policy than male colleague. 24014 begin as day where being a woman will
no longer be a pre-existing condition. A brand new day.
>> Great. I think we have time for one more question.
I know people were interested in eye care and dental care.
Wanted to know when services like those would be available to them.
>> Again, starting in 2014 in the new insurance markets which will be available one thing
that will happen is as part of a policy essential health benefits will be defined, what has
to be ever in every poll I and then people have option to add services or look at more
or less robust policies but all policy also have essential health benefits.
So starting in 2014, we will be putting as guidance the states about what essential health
benefit package has to include. There's some areas spelled out in the law,
we're looking closely at what the popular employer plans in every State offer.
What the state employee plans. What the most popular federal employee plans
using that as the guidance for what should be in insurance policies.
If you work for a big employer you're likely to have a set of benefits that looks very
similar regardless of which employer you work for, it could be the state, could be Federal
Government, could be a private employer. So that will begin to define what's in an
essential benefit package. Things like dental service and eye care and
a more robust package that makes sure if you need to go to the hospital that your hospital
stay is paid for, those kinds of things will start in the new markets in 2014.
>> Stay tuned in 2014. Unfortunately that's all the time we have
for today. Secretary Sebelius, thank you so much for
helping us answer the questions. And to all of you who joined us, if we didn't
get to your question today, you can find a list of all the services available to you
at And for more answers to your questions, go
to and search healthcare reform. Thank you so much for joining us.
>> Thank you.