Get the Most From Your New ACA Health Coverage

As we start 2019, the Affordable Care Act (ACA) remains the law! Recently, the federal judge in Texas who ruled last month that the law should be struck down declared that the ACA will remain in effect as his decision is appealed to higher courts by 17 state Attorneys General. U.S. District Court Judge Reed O’Connor stayed the effect of his own ruling, writing that otherwise, "many everyday Americans would otherwise face great uncertainty during the pendency of appeal.

That means millions of women, LGBTQ people and families are starting 2019 with health insurance they purchased through healthcare.gov and state-based marketplaces during the 2018 ACA open enrollment period. If you’re one of them, here are six insider tips from the pros at Raising Women’s Voices on how to get your money’s worth from your insurance.

1. Breathe a sigh of relief! You have quality insurance that complies with the ACA’s high standards. That means you’re covered for pre-existing conditions, hospitalizations, maternity care, prescription drugs and all the basics you’d expect a health plan to cover!

2. Pay your monthly bill on time! It’s especially important to pay that first bill--it was due December 31--so that your coverage actually goes into effect. If you haven’t paid it yet, call your health insurance company right away to work it out.

3. Schedule a FREE check-up! You get preventive care at no additional charge to you. So, make that appointment now with your primary care provider and/or ob/gyn. A woman’s annual check-up is called a “Well-Woman Visit.” If you need to see two different providers (such as a primary care provider and an ob-gyn) to get all of the needed preventive care, it’s still covered 100%. If you have children, schedule their preventive check-ups, too.

4. Find doctors you trust. The key to getting the most value out of your health plan is finding doctors and other health care providers you trust who take your insurance. A good way to start is by calling your health plan for help. Tell the representative what is important to you in a doctor, such as office location, languages spoken, gender, hospital affiliation or office hours. If you are looking for an LGBTQ-friendly doctor, try searching the glma directory. You can also ask friends, family or colleagues for recommendations. If you try a new doctor and you do not like him or her, you do not have to go back. You are entitled to try someone different next time.

5. Get FREE birth control. While you are at your Well-Woman Visit, discuss your options with your doctor and make the choice that's best for you. All FDA-approved forms of birth control must be 100% paid for by your health plan. Some brands may not be covered by your particular health plan, so discuss it with your provider before she writes the prescription.

6. Take care of your mental health. The ACA requires health plans to cover mental health care the same way they cover physical health care. You will pay a deductible or co-payment. After that, your insurance will pay the rest, without limits on the number of visits or cost, as long as you see a mental health provider participating in your health plan.

Need more help getting started with your new health insurance?  Raising Women’s Voices has created a website where you can learn much more. It’s called My Health, My Voice. There you can learn five important steps to getting started using your health plan, and understand the four types of costs you may pay to use your coverage (your monthly premium, co-pays, deductibles and co-insurance.) You can also download free copies of our publications: A Woman’s Step-by-Step Guide to Using Health Insurance and My Personal Health Journal.