Your Sexual and Reproductive Health Care and the ACA

By HealthSherpa

When you’re thinking about birth control, pregnancy, and STDs, health insurance probably isn’t the first thing that comes to mind. However, thinking about how to cover the cost of sexual and reproductive health services you want and need is something you care about.

Here’s the skinny on about how sexual and reproductive health services – as well as other key health benefits – are covered under the Affordable Care Act (ACA).


What do I need to know about the Affordable Care Act?

 There’s been lots of talk by politicians about the Affordable Care Act and making changes to it, but here’s where things stand.  The ACA has expanded access to many people who historically didn’t have insurance. Before the ACA, people could be denied coverage or charged more based on a pre-existing condition like taking medications to treat HIV/AIDS or even going through a pregnancy.

The Affordable Care Act stopped those practices and even guarantees benefits that weren’t mandatory before:

  • You can stay on your parent’s health insurance until the age of 26
  • You are entitled to essential health benefits
  • More people have access to additional coverage options – including young adults, women, and low-income individuals
  • There are no longer limits on coverage


So what sexual and reproductive health services are available under the ACA?

When you enroll in a plan under the Affordable Care Act, you will have access to preventive care services with no extra costs. Let’s look at the ones focused on sexual and reproductive health.

Preventive care services for adults:

  • Hepatitis B and Hepatitis C screenings
  • HIV screening
  • Immunization vaccines for Hepatitis A, Hepatitis B, and Human Papillomavirus (HPV)
  • STD/STI prevention counseling
  • Syphilis screening

Preventive care services for women

  • Cervical cancer screening
  • Gonorrhea, Syphilis, and Chlamydia infection screening
  • HIV screening and counseling
  • Human Papillomavirus (HPV) screening (for women 30+ with normal cytology results)
  • Sexually transmitted infection (also known as STD) counseling
  • Well-woman visits to get recommended services (for women under 65)
  • Birth control methods (e.g. pills, IUDs, implants, diaphragms and sponges)
  • Emergency contraception (e.g. Plan B® and ella®)
  • Sterilization procedures (permanent contraception)
  • Access to breastfeeding supplies for both pregnant and nursing women
  • Comprehensive breastfeeding support and counseling
  • Expanded tobacco intervention and counseling (for women who are pregnant and use tobacco)
  • Folic acid supplements
  • Gestational diabetes screening (for women 24-28 weeks pregnant and those considered high risk)
  • Gonorrhea screening
  • Hepatitis B screening (for pregnant women at their first prenatal visit)
  • Patient education and counseling
  • Rh Incompatibility screening (for all pregnant women and follow-up testing for women at higher risk)
  • Routine anemia screening
  • Syphilis screening
  • Urinary tract or other infection screening

Preventive care services for anyone under 18

  • Cervical dysplasia screening (for sexually active females)
  • Gonorrhea preventive medication (for all newborns)
  • Hepatitis B and HIV screenings (for adolescents considered high risk)
  • Immunization vaccines for Hepatitis A, Hepatitis B, and Human Papillomavirus (HPV)
  • Sexually transmitted infection (STI) prevention counseling and screening (for adolescents considered high risk)


If I enroll in an ACA plan, what other benefits are included?

Every plan under the ACA comes with essential health benefits. This means, regardless of which plan you choose, you will have access to birth control, mental health services, prescription drugs, plus more. Let’s look at the full list:

  • Ambulatory services
  • Birth control coverage
  • Breastfeeding coverage
  • Emergency services
  • Hospital services
  • Laboratory services
  • Mental health services (including substance abuse treatment)
  • Pediatric services (including dental and vision care)
  • Pregnancy, maternity, and newborn care
  • Prescription drugs
  • Preventive care and wellness services
  • Services and devices for people with disabilities


Okay, I’m ready to enroll. Now what?

In most states, Open Enrollment is from November 1 to December 15, 2018 – though in Colorado you have until January 15, 2019. This is the period where you can shop, compare, and enroll in a new health insurance plan. Plus, health insurance might be more affordable than you think. 8 out of 10 people qualify for savings under the Affordable Care Act. Some people are even eligible to pay as little as $10 per month. Make sure to mark your calendar! If you miss this window, you may have to wait a full year to enroll.

About HealthSherpa

At HealthSherpa, we believe that everyone deserves access to quality, affordable health coverage. HealthSherpa is a website that makes finding, enrolling in, and using your health insurance easy. Plus, we’re a team of advocates, ready to help you find the best option for your needs. If you’re looking to get enrolled or have questions about your health insurance, our team is ready to help. You can reach out to our Consumer Advocates at (855) 460-4003 — or grab a quote here.