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New Rules to Require Health Plans to Cover Preventive Services Without Charging Deductible or Co-Pay

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Congresswoman Chellie Pingree said today that new rules requiring health plans to cover preventive services without charging a deductible or co-pay will save millions of lives and billions of dollars in health care expenses.

"Thousands of Maine families will be able to get basic preventive care like mammograms, diabetes screening and routing immunizations without any out-of-pocket expense," Pingree said. "These new rules will save thousands of lives every year and bring down costs because it is far more cost effective to treat diseases like cancer when they are detected early."

Today, the Obama Administration announced that for new health policies beginning on or after September 23, 2010, preventive services must be covered and plans can no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider.

Pingree said the new rules will benefit nearly every American, but highlighted the benefits for women, seniors and children.

"Women will now have access to things like annual mammograms and blood pressure screening without paying a deductible," Pingree said. "For seniors some of the benefits include annual physicals and diabetes and cancer screening without a co-payment. And the new rules mean parents can take their children in for well-baby and well-child visits until they are 21 without any out-of-pocket expenses."

Pingree also said the new rules will help women access reproductive health services without incurring out of pocket expenses.

According to Pingree the new rules will save thousands of lives and billions of dollars in health care expenses every year.

"If Americans took advantage of just five preventive services--colorectal and breast cancer screening, flu vaccines, and counseling on smoking cessation and regular aspirin use--over 100,000 deaths could be averted each year," Pingree said.

Below is a summary of some of the additional benefits that will be available under the rules announced today:

For women:

· Screening for conditions that can harm pregnant women or their babies, including iron deficiency and hepatitis B
· Special, pregnancy-tailored counseling from a doctor that will help pregnant women quit smoking and avoid alcohol use
· Counseling to support breast-feeding and help nursing mothers
· Annual mammograms for women over 40
· Regular Pap smears to screen for cervical cancer and coverage for the HPV vaccine that can prevent cases of cervical cancer

For seniors:

Beginning January 1, 2011, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for most preventive services and Medicare will cover the cost of an annual wellness visit with your physician.

In addition, the following preventive services that Medicare currently covers will be provided free of charge to the patient, including:

· Mammograms every 12 months
· Colorectal cancer screening
· Cervical cancer screening, including a Pap smear test and pelvic exam
· Cholesterol and other cardiovascular screenings
· Diabetes screening
· Prostate cancer screening
· An annual flu shot

For children:

· Well-baby and well-child visits: This includes a doctor visit every few months when your baby is young, and a visit every year until your child is age 21
· Screenings and counseling to prevent, detect, and treat common childhood problems like obesity, depression among adolescent children and dental cavities
· Immunizations like an annual flu vaccine, and many other childhood vaccinations and boosters, from the measles to polio


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