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New guidance on Obamacare birth control rule

Obamacare means never having to say, "Here's some money for my birth control."

The Obama administration on Monday rapped health insurers on the knuckles, strongly reminding them that they have to cover all approved birth control methods without forcing women to pay out-of-pocket for the medication or devices.

The U.S. Health and Human Services Department also issued guidance reinforcing insurers' obligations under the Affordable Care Act to pay for a slew of services at no extra charge to their customers.

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The moves follow reports a few weeks ago that insurers were often ignoring the Obamacare contraception rule, and days after New York's attorney general sought information from insurers about how their plans are covering contraception.

A New York Times story in late April said researchers found some insurers were only covering one or two forms of birth control, out of the 18 separate approved methods, or they were refusing to provide contraception coverage without out-of-pocket payments to women over certain ages.

Birth control pills
Ale Ventura | PhotoAlto | Getty Images

In addition to the birth control-related guidance released Monday, HHS moved to protect transgender people from efforts to limit preventative services based on the "sex assigned at birth, gender identity or recorded gender."

For example, the administration said, if a doctor recommends a medically appropriate preventative service such as a mammogram or pap smear for a transgender man "who has residual breast tissue or an intact cervix," the insurer must cover the service without insisting that the patient cover some of the costs by paying out of pocket.

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HHS' guidance also clarified some of the preventative services where insurers shouldn't seek out-of-pocket payments. For example, women at increased risk of having the BRCA-1 or BRCA-2 cancer susceptibility gene must have preventive screening, genetic counseling and testing for the gene covered at no extra cost to them if they were not previously diagnosed with BRCA-related cancer, HHS said.

And dependent children covered by a health plan must have preventive services covered at no out-of-pocket cost, HHS said. The agency added that no payment should be imposed for anesthesia services performed as part of preventive colonoscopies.

A key part of Obamacare is the requirement that insurers cover a menu of preventative services without imposing "cost sharing" on enrollees in their plans. Cost sharing refers to co-payments, deductibles, co-insurance and other payments that patients pay out of their own wallets, as opposed to the monthly premiums they pay for their health coverage.

"These recommended preventive services are designed to help people stay healthy and to catch illnesses early on, when treatments can be more successful and costs are often lower," HHS said Monday in a press release.

HHS Secretary Sylvia Burwell said, "The Affordable Care Act was a major step forward in helping women to get the health-care services they needed to stay healthy."

"Tens of millions of women are eligible to receive coverage of recommended preventive services without having to pay a co-pay or deductible, including contraception," Burwell said. "Today, we are clarifying these coverage requirements."