Women's health insurance rights

Under state law (apps.leg.wa.gov), health insurance companies must give female patients direct access to women's health care providers and to allow them to self-refer to services, such as:

  • Maternity care
  • Reproductive health services
  • Gynecological care
  • General exams
  • Preventive care

Women’s health care providers include:

  • Licensed specialty doctors, such as gynecologists and obstetricians
  • Licensed physician assistants or registered nurse practitioners specializing in women's health and midwifery

Your health insurance company must allow you to:

  • Choose a participating women's health care provider from its network provider list
  • Self-refer to a network provider to receive women's health care services

Health reform for women's health services

Starting Jan. 1, 2014, most health plans must provide additional preventive health services for women. Also, all individual health plans and small group health plans must cover a list of preventive services (www.healthcare.gov), such as:

  • Well-woman visits (including routine breast and pelvic exams)
  • Gestational diabetes screening
  • HPV (human Papillomavirus) testing
  • Counseling for sexually transmitted infections
  • Domestic violence screening
  • Breastfeeding supplies
  • Prescription contraceptives

In addition, if you receive these preventive services from a network provider for an individual or small group plan, you won't be charged a copayment, coinsurance, or have the charges applied to your annual deductible.

Updated 03/27/2014

See also

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