Glossary

Term · California: Leave, Money, and Paperwork

Women's Preventive Services Guidelines

Also: WPSI guidelines, HRSA women's preventive services, preventive services guidelines for women

US federal guidelines listing preventive care that most health plans must cover without a copay, including breastfeeding support, supplies, and counseling.

In plain words

The Women's Preventive Services Guidelines are US federal recommendations for preventive health care for women. Under the , many health plans must cover the services they list without a copay. For pregnancy and feeding, the list includes breastfeeding support, supplies, and counseling, which can include a breast pump. Coverage depends on your plan, the type of pump, and where you get it. Your insurer can tell you what your plan covers. Rules can differ for employer plans, grandfathered plans, and some other plan types.

The deeper version

The Women's Preventive Services Guidelines were developed by the Health Resources and Services Administration (HRSA) on recommendations from the Institute of Medicine (2011), and they set the minimum coverage content under Affordable Care Act section 2713. The breastfeeding support, supplies, and counseling guideline, updated since its first release, recommends comprehensive support and access to a breast pump for lactating individuals, with coverage requirements that apply to most private plans. Exemptions exist for grandfathered and certain small-employer plans, and enforcement and implementation have varied across states. The debate centers on whether the device requirement reaches all mothers in practice, especially for certain pump types and for women who stop breastfeeding early.

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Sources

  • Health Resources and Services Administration — Women's Preventive Services Guidelines: Breastfeeding Services and Supplies
  • Institute of Medicine — Clinical Preventive Services for Women: Closing the Gaps, 2011
  • US Congress — Patient Protection and Affordable Care Act, section 2713, 2010

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