The essential health checkup for women — and how Obamacare can help

Aisha Langford

The Affordable Care Act, also known as Obamacare, introduced a major benefit for women: expanded health coverage.

Women now have access to free preventive care services including checkups, family planning counseling, and routine screenings for diseases such as breast cancer, cervical cancer and diabetes.

Screening tests can find diseases early and when they’re easier to treat. Your doctor may screen you at an earlier age than generally recommended, or more often if you have a family history or risk factors that increase your chances of developing a condition.

There are specific conditions for which all women should get checked. The screening tests discussed in this article are covered by all Affordable Care Act health plans and don’t require co-pays.

Always check your insurance plan for specific details about what services are covered and how often.

1. Cervical cancer.

Cervical cancer used to be the leading cause of cancer death in women in the U.S. – however, thanks to more and more women getting Pap tests, the number of deaths has decreased significantly.

However, in 2011 (latest statistics available), over 4,000 women died from cervical cancer in the U.S.

Cervical cancer is discovered through a Pap test. Women age 21 to 29 can get a Pap test every three years by a primary care provider or a gynecologist as part of a well-women exam or routine checkup.

Women age 30 to 65 can get a Pap test plus the human papillomavirus (HPV) test every five years. The HPV test checks for the virus that causes abnormal changes to the cervix (cervical dysplasia). These changes can develop into cervical cancer over time.

In general, women can stop screening for cervical cancer at 65. If you’re over 65 and have a history of cervical cancer or dysplasia, talk to your health care provider about whether you should continue screening.

2. Breast cancer.

A mammogram (an X-ray of the breast that helps find tumors too small to feel during a self-exam or clinical exam) is the most common screening tool for breast cancer.

Women generally begin getting mammograms at age 40 and get them annually until age 74. Your primary care provider can schedule your mammogram or refer you to a breast-imaging center.

Carrie Riccobono, a clinical nurse specialist and certified oncology nurse in Wisconsin, recommends that women do their research on breast-imaging centers so they can get the best care.

For example, you may want to ask the center if they have breast-imaging radiologists who read more than 2,500 mammograms per year.

“Radiologists who specialize in breast care have better detection rates than general radiologists,” Riccobono says.

3. Colorectal cancer

Starting at age 50, women can get a colonoscopy every 10 years. During a colonoscopy, doctors look for polyps (a small growth from a mucus membrane) and abnormal changes to the colon and rectal tissue. Polyps have the potential to turn into cancer.

Alternatively, women can get a fecal occult blood test (FOBT) every year. A FOBT requires sending stool samples to a lab to have them checked for blood. Blood in the stool is a potential sign of colorectal cancer.

A third option is to have a sigmoidoscopy every five years coupled with a FOBT every three years. Unlike a colonoscopy in which the provider can see the full colon and rectum, a sigmoidoscopy only allows providers to see the lower part of your colon and rectum.

4. Sexual transmitted infections (STI).

The Centers for Disease Control and Prevention estimate there are 20 million new cases of sexually transmitted infections (STIs) in the U.S. each year. Anyone who’s sexually active is at risk.

A gynecologist or primary care provider will ask about your sexual history and current behaviors. Depending on your situation, your doctor may recommend you get screened for chlamydia and gonorrhea — two of the most common STIs.

Both infections can make it difficult for women to get pregnant and can cause other health problems, such as scar tissue in the fallopian tubes.

5. Birth control and fertility screening.

If you’re a sexually active woman, be sure to discuss birth control methods with your doctor. The right option for you will depend on your health, concerns about side effects, and comfort with the method.

For women under 35, infertility means not getting pregnant after one year of trying. For women over 35, infertility means not getting pregnant after six months of trying. If you want to get pregnant, but are having difficulty, talk to your gynecologist or primary care doctor about your options.

The Affordable Care Act doesn’t require coverage for infertility treatments and only 15 states require that insurance companies cover infertility treatments for women, so be to check your plan.