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Health Insurance Guide For Women

Alvin Nelson
February 18, 2021
Alvin Nelson

Health Insurance Guide For Women

Insurance and taxes are never fun topics. Insurance in particular is a ‘product’ that people buy to be on the safe side to cover themselves in case of unforeseen incidents. Claims are often made under not-so-great conditions and people would rather not make them.

However, health insurance is a little different. It offers some coverage that isn't exactly unwanted. For women, in particular, this is invaluable.

Health Insurance for Women - The Situation

Women have some rather unique health requirements. At the forefront is pregnancy and other maternity needs. These are almost always covered in women's health insurance policies.

Then, some other health conditions are common in women such as heart disease, breast and cervical cancer, and stroke. If one has other risk factors for these conditions, active health insurance is highly recommended for them.

The Affordable Care Act has had such a huge impact on women's health, from improving access to patient care and even the coverage offered. Irrespective of the upside and facts and figures, insurance is still a bit of a hassle.

Fortunately, we’ve got the lowdown on everything related to women’s health insurance information. That said, here's a quick guide to all things health insurance for women.

Let’s start with the sources of health insurance coverage

  1. Employer-sponsored insurance

Employers play a huge role in health financing. A high number of women (58.6 million in 2018) received health benefits through either their own employer or a family member’s.

This is often distinguished by the company size (small group market and large group market) as well as the employer’s insurance arrangement (fully insured and self-insured).

This type of insurance is great for several reasons, including:

  • Most employers do a good job of selecting high-quality plans.
  • It spreads costs and risks among a group of people.
  • It’s easier for employees to maintain coverage and take care of their premiums efficiently here. [1]
  1. Non-group insurance

This allows individuals to purchase insurance coverage for health purposes. It offers premium tax credits to help with the purchase in state-based health insurance markets.

This isn’t as common as the former, but a significant number of women (8.1 million) purchased insurance this way in 2018.

  1. Medicaid

As of 2018, 17% of non-elderly adult women were covered by Medicaid. Thanks to the ACA, most states that have expanded for Medicaid now cover for a wide range of issues that fall under several categories previously excluded.

Possible categories include low-income women, pregnant women, birth financing and family planning services, and breast and cervical cancer treatment. [2]

Health Insurance Coverage Eligibility under Medicaid

The above mentions are rather generic and also dependent on the source of insurance. The following should provide more than just a perfunctory description.

Firstly, the woman's state of residence must have expanded Medicaid. This information can be found by visiting the state's Medicaid website. Afterward, an application can be filled out to discover exactly what kind of coverage one is qualified for. [3]

ACA (Obamacare) Health Insurance for Women

  1. Essential health benefits

As the name implies, this provides coverage for health issues deemed essential regarding women.

This includes

  • Doctors’ services
  • Inpatient and outpatient hospital care
  • Coverage for prescription drugs
  • Pregnancy and childbirth
  • Mental health care
  • Emergency services
  • Pediatric services.

The above is pretty standard. Some insurance policies offer more coverage options, for a higher price.

  1. Preventative measures

Preventative healthcare is often not given as much credit as it should be. Perhaps, women feel they're not essential, therefore, shouldn't have to incur an extra cost.

However, preventative measures could potentially save you a lot more money at the end of the day.

Those covered by insurance include

  • Annual “well-woman” check-ups
  • HPV testing (screening for cervical cancer)
  • Screening for gestational diabetes
  • Mammograms
  • Domestic violence screening and counseling
  • Food and Drug Administration (FDA) approved contraceptives
  • Breastfeeding support and services
  • Osteoporosis screening. [4]
  1. Pre-existing conditions

Insurance companies aren't allowed to refuse one coverage for pre-existing conditions. They also cannot charge more for them.

Conditions such as asthma, diabetes, and cancer, fit this bill. This applies most especially for conditions the woman had before the new insurance coverage starts. Pregnancy is also covered here if the woman is pregnant when she applies. It could also start counting from the day of enrollment. [5]

Average Cost of Health Insurance For Women

It probably doesn't come as a surprise to you that health care is expensive. Insurance makes this way more affordable and accessible.

But just how affordable is it?

For starters, there’s often a price disparity between private and publicly funded insurance programs. Then, there is the “Gender-rating” where women pay more (sometimes up to 50% more) for health insurance than men.

Why?

Because women pose more insurance risks since they visit the doctor more often, live longer, and of course, incur the risks associated with pregnancy and childbirth.

For instance, a Denver Post review showed that women in the city would pay $420 more than men for the same coverage. [6]

Luckily, the ACA was implemented. Now, the majority of health plans provide maternity benefits.

The average national cost for health insurance (2020) is $456 for an individual and $1,152 for a family. This figure is for a premium ACA plan. Previously, women would have had to pay more for this, but the ACA policy has removed this disparity. For a single individual, the yearly deductible costs around $4,364.

The ACA does offer varying health plans. These plans are grouped under four different categories: bronze, silver, gold, and platinum.

Each plan varies with coverage with the bronze plan offering the least and platinum, the most.

Quick Mini-Guide[7]

PLAN

COST

COST OF CARE

DEDUCTIBLES

ACTUARIAL VALUE*

DAILY STARTING PRICE [8]

Bronze plan

$448

Lowest

Can run in the thousands

60%

$1

Silver plan

$483

Moderate

Lower than bronze plans

70%

$3.33

Gold plan

$569

High

Low

80%

$4.99

Platinum plan

$732

Highest

Very Low

90%

$6.67

 

*Actuarial value – measures the percentage of health care costs covered by the health insurance plan.

Insurance Marketplace

Health insurance marketplaces (exchanges) are organizations whose purpose is to make buying health insurance more organized. 

It also sets up competitive marketing that provides a wide variety of health plans, information, and even assistance for potential clients.

The employer-sponsored insurance as we mentioned above falls under this category. [9] The non-group insurance, however, usually comes into play when someone isn't eligible for Marketplace. Most states have a marketplace for individuals, families, and small businesses.

Other Options For Receiving Great Health Insurance Services for Women

Despite the existence of Marketplace, finding the right insurance policy with appropriate coverage isn't the easiest of jobs.

Not to worry, we've got good news for you!

At healthplans.com, we're an independent marketplace that will provide you with quotes from multiple sources so you can compare prices and maximize your insurance coverage.

All you have to do is input your zip code and complete a personal interview.

We'll provide you with health insurance plans for your area. Simply choose a plan that suits your budget and lifestyle and go for it.

To find a health insurance plan for yourself with minimal stress, apply today.

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