Jul. 28, 2014   61°F   School Closings
Listen Live WCPN / WCLV
ideastream
Mission 4
Values 1
Values 2
Values 3
Vision 3
Vision 4
Vision 5
Values 4
Values 5
Values 6
Vision 1
Vision 2

Choose a station:

90.3 WCPN
WCLV 104.9
WVIZ/PBS

Choose a station:

90.3 WCPN
WCLV 104.9
WVIZ/PBS

Few Public Family Planning Centers Accept Insurance, Yet

Posted: February 19, 2013

Share on Facebook Share Share on Twitter Tweet

The federal law overhauling health care requires that contraceptives be made available to insured women without any out-of-pocket costs to them. Many family planning clinics aren't yet set up to accommodate women under those terms.

Health plans are required to pay for contraceptives, but the clinics that are common sources of family planning services aren't used to dealing with insurers.

Health plans are required to pay for contraceptives, but the clinics that are common sources of family planning services aren't used to dealing with insurers.

Most women can expect to get contraceptives without paying out of pocket for them thanks to the federal Affordable Care Act.

Women who are young or those who are poor and rely on publicly funded family planning centers for reproductive health services are covered, too.

But there's a catch. Many of the state and local health departments, community health centers, Planned Parenthood clinics and other family planning centers that serve these women don't accept insurance, not even publicly funded insurance such as Medicaid. Not yet, anyway.

To take advantage of required insurance coverage of these benefits under the law, the centers will have to learn the ins and outs of contracting with insurers and beef up their computer systems pronto, according to a study by the Guttmacher Institute, a reproductive health organization.

"If your patient has insurance but you as a clinic don't take insurance it's not going to do you much good," says Adam Sonfield, an analyst at the Guttmacher Institute who co-authored the study.

It won't do patients much good either. Roughly a quarter of women who need birth control rely on publicly funded family planning centers.

In 2010, family planning centers reported that only 60 percent of their clients had public or private insurance, according to the Guttmacher report. Some women receive services through state or federal programs like the Title X family planning program, while others pay out of pocket, often on a sliding scale based on income.

Under the health care overhaul that will change drastically. Starting in 2014, most people will be required to have insurance or pay a penalty. Medicaid eligibility will expand in many states to people with incomes up to 138 percent of the federal poverty level and many other people will be eligible for subsidized coverage on state-based health insurance exchanges.

And the health law requires new plans or those that lose their grandfathered status to provide a range of preventive benefits, including birth control, without patient cost-sharing.

The Guttmacher study found that overall, only a third of family planning centers had contracts with private insurers in 2010. Forty percent had contracts with Medicaid health plans.

"For all family planning centers, becoming adept at working with health plans as a way to secure third-party reimbursement for insured clients will be necessary to thrive in the emerging health care marketplace," the report concludes.

Copyright 2014 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

Tags

Shots - Health News

Leave a Comment

Please follow our community discussion rules when composing your comments.