The Affordable Care Act and You! 5 Facts Moms Need to Know

The Affordable Care Act and You! 5 Facts Moms Need to Know

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Making sure your baby is healthy isn’t a choice, it’s a right!

The dust has settled on the Affordable Healthcare Act for 2014. Or has it? Did you know that Open Enrollment for 2015 starts in less than 5 months?  (The site goes live on November 15, 2014 and is open until February 15, 2015.) A lot of people are still confused about the Affordable Care Act (ACA), what is and how it affects their families.  And who can blame them?  Even those of us who work in this field find ourselves scrambling for the “right” answers.

There are a few facts that haven’t changed since the ACA’s start.  Here are just 5 key points that ALL moms need to know when it comes to navigating through the Affordable Healthcare Act:

1.     Insurance companies are MANDATED to cover ALL children through age 19! Young adults (between ages of 19 and 26) are now allowed to stay on their parents health plan unless their employers offer health insurance.

2.   No PRE-Existing Conditions carve-outs: That means that neither you nor your children can be denied insurance coverage due to a pre-existing condition like asthma and diabetes, a practice that once left about 17.6 million kids uninsured. Even better?  Insurance companies cannot charge higher rates for members with pre-existing conditions.

3.   Pregnancy and pre-natal care is a covered benefit.  For those of us who had our children in the early 2000’s it’s a relief to know that pregnancy is no longer considered a “pre-existing condition” for which we could be denied coverage.  Women-specific tests that are now covered under the ACA include:

  • Well-woman visits
  • Gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases.
  • Domestic and interpersonal violence screening and counseling.
  • FDA-approved contraceptive methods, and contraceptive education and counseling.
  • HPV DNA testing, for women 30 or older.
  • Sexually transmitted infections counseling for sexually active women.
  • HIV screening and counseling for sexually active women.
  • Mammograms and Colonoscopies (since Sept 2010)

Further, and this is one that is near and dear to my heart, um, breast: Breast pumps are also a covered benefit under the ACA. In fact, Breastfeeding support, supplies, and counseling are all covered benefits.

4.   “You don’t eat in the bathroom, why should my child?”  How many times have you wanted to say that to someone who glared at you while you were nursing your baby?  Employers MUST offer a non-bathroom private space for breastfeeding moms to pump during the work day (for at least a year after childbirth

5.  Preventative Care including Immunizations for your children are a covered benefit.  All newborn care is considered a “preventive service” under the ACA. Providers have to give immunizations and other preventive health services for infants, children, and adolescents without any cost sharing.

6.   Not Everything Has Gotten Easier:  While critics may cite the many problems with the ACA, many folks are benefitting from this legislation.  However, one of the biggest downsides that I discovered has to do with changes to Flexible Spending Accounts. In past years it was easy to submit receipts for over-the-counter medication (OTC) like cold medicine or eye drops to one’s Medical Flexible Spending Account and be reimbursed for the cost.  Not anymore.  Now you have to get a prescription from a physician if you want to receive reimbursement. Finally, the largest allowable amount of money that may be included  in your Medical Savings Account was decreased  to $2500.

Want more information about the Affordable Care Act and how it affects you and your family, please visit the government website at www.healthcare.gov