Grandfathered Group Plan Denying Well-Woman Visits?
I am a teacher in SC with health insurance through the state’s health plan under Blue Cross Blue Shield. This insurance does not cover an annual gynecological visit nor birth control pills. I have contacted my insurer to ask why they don’t have to cover this under the Affordable Care Act and they said they are grandfathered in.
However, I did not obtain this health insurance until September 2011 and I thought I read that you were automatically not grandfathered in if you got health insurance after March 2010. I am so confused as to why the state health wouldn’t cover an annual well-woman visit when the majority of the state’s teachers are young females who only go to the doctor for a well-woman visit. I appreciate any help you can offer me in explaining why this service isn’t covered by South Carolina’s state health plan.
Answer
Group plans established before March 2010 are grandfathered, this can remain true even if an employee joined after that date. Grandfathered plans can deny a number of services including important women's health services and can deny preexisting conditions. So this is all by the book.
The above being said... the idea that South Carolina schools, BCBS, and whoever else in the loop is just accepting that denying women's health services in 2015 is OK reaffirms why we need less of that thinking and more of a focus on healthcare reform. Really sorry you are subject to this.
Learn more about Grandfathered Plans from HealthCare.Gov.
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This is why we need to repeal Obamacare and make it better. My daughter has had the same problem and cannot even afford insurance on the exchange and yet Missour did not opt to expand their options so she gets no help there either.
I had my well woman check up at my gynecologist, i did not pay a copay but now the lab company is now charging me for lab work.I thought this too was covered at no cost to me