- Preventive screening, genetic counseling and BRCA genetic testing for women at increased risk for having a potentially harmful mutation in genes that suppress cancerous tumors.
- Prenatal care and other services to promote healthy pregnancies. The requirement applies to insurance plans that cover children as dependents.
- Certain preventive services for transgender people. For example, a mammogram for a transgender man who has residual breast tissue or an intact cervix.
On birth control, insurers will be required to offer at least one no-cost option in each FDA-approved category. These include daily birth control pills as well as longer-acting hormonal patches and IUDs, and the morning-after pill. The option provided can be a generic, but if a woman’s doctor says a more expensive alternative is medically necessary, the plan must cover it without a copay.
Insurance billing is notorious for breaking down procedures into different subcategories. The new rules made it clear that patients can’t be billed a copay for anesthesia during a colonoscopy.
“The plan or issuer may not impose cost sharing with respect to anesthesia services performed in connection with the preventive colonoscopy if the attending provider determines that anesthesia would be medically appropriate for the individual,” HHS said in its guidance document.