First of all, we just want to say how touched we are by everyone's support as we launched our online presence. From the kind words from previous clients to the compliments on Jacqueline's previously-unknown abilities to craft websites we've been in a constant state of blushing these past 24 hours. If you haven't already, please hop on over and like our page on Facebook too. We'll love you even more!
When considering blog topics that might be of interest, we seem to see the same sort of entries from doulas across the country. No shame there. We're a passionate group. We love helping new moms! But one thing that makes Derby City Doula unique is the power of an owner who is also a professional government relations consultant. All that insurance/coverage/bureaucracy stuff that make your eyes glaze over? You still need to know about it, right? Right. We're going to help you. If there is a specific topic (insurance or otherwise!) that you'd like us to address in the future, go ahead and let us know. We'll do our best.
So for this first topic we're going to tackle a biggie. The Affordable Care Act. AKA "Obamacare. AKA 'ACA" (see what we did there....darn bureaucrats and their acronyms). It doesn't matter which side of the aisle you're on, this federal law passed in 2010 affects you. There are good arguments both for an against it. We won't go into those here. What we want to highlight are some of the parts of the law that affect pregnant women and new moms. We can get into detail about the specifics in later posts. Here are some of the largest changes for women post-ACA:
- Prenatal Coverage - ACA sets mandatory minimum coverage for all commercial non-grandfathered* plans. These are called the "Essential Health Benefits" or "EHB". Almost all commercial (non government/medicaid/medicare) plans must cover these EHB, including coverage for pregnancy related costs. Many preventative services associated with your pregnancy like the gestational diabetes test and folic acid supplements will not only be covered but covered with no cost-sharing (no deductible, co-insurance, or co-pay) You may still be limited to your plan's network so check with the number on the back of your insurance card when choosing a new provider, but you should have some sort of coverage for checkups with an obstetrician or midwife.
*(umm what?) Grandfathered plans are basically insurance plans that haven't changed ANYTHING since 2010 and are therefore allowed to stay as-is. Each year we see fewer of these because insurance companies need to adjust ratings, prices, and coverages eventually and when they do these plans aren't considered "grandfathered" anymore. If your plan is "grandfathered" a lot of this won't apply. But you may want to check out your options at healthcare.gov to see if an exchange plan there might be a better deal for your family.
- Breast Pumps - Same deal with maternity coverage. Most commercial plans will now provide a quality double electric breast pump free of charge. Take advantage of this great benefit! You will likely be required to use an in-network medical supply company so just call the number on the back of your insurance card to get the specifics for your plan. Several of the larger plans here in the Kentuckiana area include Babyology in their network so you may be able to still shop local even if it's with your insurance company's money!
- Guaranteed Issue for Women - Insurance companies can no longer deny coverage or charge a higher premium solely because you are female. Your previous pregnancy related conditions are also no longer considered "pre-existing" for purposes of denying coverage or increasing price. In the past, having a previous cesarean birth was a reason you could be denied coverage. This is now illegal.
- Expanded Medicaid coverage. This is a very controversial point, and not available in all states, but here in Kentucky the governor issued an executive order that expanded Medicaid coverage for lower income families. Those who previously did not qualify for this coverage may now be eligible. Check with KYNECT to see if your family qualifies.
- Easier access to OB/GYNS - You no longer need a referral to see an MD who specializes in obstetrics
There are plenty of other provisions (it IS over 6000 pages, after all) but these are some of the biggest points that affect pregnant women and/or new moms. Do you have any questions about the Affordable Care Act? Did you know it affected you?