Women’s preventive health benefits
Posted on June 5, 2012
Notice for HNE Fully Funded Subscribers
HNE is preparing for implementation of the women’s preventive health benefits as required by the Affordable Care Act (ACA). The services are all generally covered today, but they are subject to a plan’s deductibles and copays (or other applicable plan cost-sharing).
Effective August 1, 2012, HNE will no longer have cost-sharing for the ACA-required women’s preventive health services. For more information on women’s preventive health services, go to: http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html.
We have attached a copy of an amendment to the HNE Explanation of Coverage that describes these changes. If you have any questions, please call HNE Member Services at 413.787.4004 or 800.310.2835. Our staff is available Monday through Friday, 8:00 a.m. to 5:00 p.m.
Sincerely,
Peter P. Lore
Member Services Manager
AMENDMENT 03-2012
This is an Amendment to your Health New England, Inc. Explanation of Coverage (EOC). Please keep this Amendment with your EOC as it changes the terms of that EOC. Any language in the EOC that is inconsistent with the terms of this Amendment no longer applies. This Amendment is effective as of August 1, 2012.
The EOC is amended as follows:
HNE provides coverage for the preventive health services listed below. For services provided by an in-Plan provider, the services are covered in full. There is no copay, co-insurance, or deductible for these services when provided in-Plan.
- Well-women visits
- Screening for gestational diabetes
- Human papillomavirus (HPV) testing
- Counseling for sexually transmitted infections
- Counseling and screening for human immunodeficiency virus (HIV)
- Contraceptive methods and counseling*
- Breastfeeding support, supplies, and counseling
- Screening and counseling for interpersonal and domestic violence
This coverage is required under the Affordable Care Act (also known as Federal Healthcare Reform). HNE already covers many of the services listed above with no member copay, co-insurance, or deductible. Starting on August 1, 2012, HNE will cover those services not already covered (such as breastfeeding services and certain birth control prescription drugs and devices), without a copay, co-insurance, or deductible.
As with any covered service, HNE will continue to monitor the effectiveness and cost of the covered services, as well as any ongoing changes to regulatory requirements. HNE may adjust benefits accordingly based on these considerations.
* $0 coverage limited to certain contraceptive methods, certain generic prescription drugs, and certain devices. For a list of these devices and prescription drugs, go to http://www.hne.com/HNE_Pharmacy/formulary.html.
- Under OR search by one or more of the following: go to the Copayment Tier/Status drop down and select $0 Copay
- Go to the Therapeutic Class drop down and select the item you are looking for (Contraceptives, Oral Contraceptives, etc.).
- Be sure to select August 1, 2012 in the date field. The $0 coverage is not effective before that date. If you do not choose August 1, 2012 in this field, your search will not indicate any results.
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