In addition, small businesses with fewer than 25 full-time employees who make $50,000 or less a year may be eligible for tax credits to help owners purchase health insurance for their employees. Small businesses will also have access to specialized marketplaces called the Small Business Health Options Program (SHOP) that will help them compare the costs and benefits of insurance options for their employees. 2. BETTER COVERAGEThe law requires that all individual and commercial plans cover at least 10 categories of benefits, known as essential health benefits. These include:
All outpatient medical careMental health and substance abuse servicesEmergency servicesHospitalizationPrescription drugsPediatric services, including dental and vision careRehabilitative (including devices) and “habilitative” care, including autism treatmentLaboratory servicesPreventive, wellness, and chronic disease servicesPrenatal, maternity, and newborn care
Even if you’re not in the baby-making demographic, it’s good to know that your daughter or niece is protected. Today, few states require coverage for maternity care in the individual market, leaving millions of women uninsured when they have a baby. Nearly 7.5 million women are expected to gain maternity coverage on the individual market. Plus, between state Medicaid expansions, health insurance exchanges, and employer mandates, it’s estimated that about 19 million women will gain health insurance, with slightly more than half of them eligible for subsidized coverage through the marketplaces. Many are between ages 50 and 64—too young to qualify for Medicare but possibly burdened with significant medical bills. 3. FREE PREVENTATIVE CARESome ACA components have already taken effect—all of which are key for women, says Usha R. Ranji, associate director for Women’s Health Policy at the Kaiser Family Foundation in Menlo Park, CA. Nearly one out of five women under age 65 is unable to find or afford health insurance. A major boon, particularly for women, will be free preventive care. Co-pays for recommended services, including mammograms and Pap tests, as well as breast-feeding support and breast pumps, are free for women who have private insurance. Now many women can get an annual “well-woman” visit, which includes prenatal care and contraceptive counseling, as well as all recommended preventive services, at no cost. Also covered are contraception, HIV and other sexually transmitted disease screenings and counseling, and services such as screening and counseling for domestic violence. (You can see the full list here). “The well-woman visit is a fantastic opportunity for women to take care of themselves,” says Therese Fitzgerald, PhD, who directs the policy and advocacy program at the Connors Center at Brigham and Women’s Hospital in Boston. “It’s something we may not do because we’re so busy taking care of everyone else.” Be aware: Your doctor’s office may not know about the free checkups. You may need to offer a reminder. More from Prevention: ACA State Exchanges 101
