New Commonwealth Fund Brief Examines Exclusions in Health Insurance Plans that Place Women’s Health at Risk

Do consumers know what is excluded from their health insurance plan? Health insurance plans often include long lists of excluded services. These lists of excluded services carve out various services such as acupuncture or treatment of injuries arising from an act of war.

A recent issue brief, published by the Commonwealth Fund and written by Dania Palanker and Karen Davenport for the National Women’s Law Center, explores six exclusions found in health insurance plans offered on the exchanges that limit women’s access to care. The brief found exclusions can put women at risk by leaving gaps in coverage. For example, the brief found that over 40% of plans excluded services arising from non-covered services. While it may seem reasonable that plans exclude non-covered services, as written these exclusions suggest plans would deny coverage for complications such as an infection following a prophylactic mastectomy or a life-threatening reaction to a non-covered prescription drug.

The brief also discusses the lack of transparency related to health insurance that means women, and other consumers, are likely unaware of what services are excluded when they enroll in coverage.

The authors propose several actions that federal and state officials can take to limit insurance company practices that disproportionately harm women’s access to needed health care services. Download the full brief here.

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