Women's Health

If you are concerned about a family history of breast and female cancers, talk to your doctor about your risk and the possibility of being tested for BRCA1 and BRCA2, genes that increase risk of breast and ovarian cancers.

We require preapproval for genetic testing to protect customers from unexpected bills. Your in-network healthcare provider can request approval for you. When done without a cancer diagnosis, the test is considered preventive and covered at 100 percent under most health plans. Breast cancer preventive medications are covered for women who have had breast cancer or whose BRCA test revealed higher risk.

Premera covers mammograms, subject to the terms of specific plans, based on what you and your healthcare provider decide is best for you, your risks, and preferences.

One mammogram per year is considered preventive under most health plans. We also offer coverage for computer-aided diagnostic and 3-D mammography. If you're having a mammogram as a result of an abnormality, it will be billed as a diagnostic test and is subject to coinsurance or deductible.

Sometimes a doctor will recommend an ultrasound or magnetic resonance imaging (MRI) in addition to a mammogram. That is typically billed as a diagnostic test and is subject to coinsurance or deductible.

If you’re referred for additional breast or cervical cancer screening, a Premera nurse might call to offer support and answer any questions you might have.

If you are having trouble conceiving, some tests can be done to evaluate the issue. Available for men and women, these tests are billed as medical tests and are subject to copay and deductible. Hormone tests and labs are covered if they're not coded for infertility.

Fertility enhancement medications and treatments, such as in-vitro fertilization (IVF) are not covered on most plans. Some employer-sponsored plans do cover it. Check your benefit booklet or ask your plan administrator.

If contraceptives are prescribed for birth-control reasons, many generic options will be covered with no out-of-pocket cost to you on most plans. If you are a member, go to Prescriptions to see if your preferred brand is covered on your plan.

Sometimes doctors prescribe birth control for other issues, such as balancing hormones or acne, which would not be covered at 100 percent by your plan. Talk to your doctor about finding the right option for you.

FDA-approved methods of birth control are covered with a written prescription under most plans, including:

• Barrier methods, like diaphragms, condoms, spermicide and sponges
• Hormonal methods, like birth control pills, patches, and vaginal rings
• Implanted devices and intrauterine devices (IUDs)
• Emergency contraception
• Sterilization procedures, such as tubal ligation (tying the fallopian tubes) or implants
• Patient education and counseling with your doctor

Some plans might not cover contraceptives. Check with your group administrator or benefit booklet for information specific to your plan.

Many health plans cover abortion procedures, though some employer-sponsored plans don't. Check your benefit booklet to confirm.

Plans purchased on the Washington Healthplanfinder or HealthCare.gov require that money used for abortion benefits go into a separate fund. This is noted on your statement. No federal funds are used for terminations of pregnancy.

Menopause is the time in your life when your period stops for at least 12 months.

Some women go through menopause without symptoms, but most have one or more of the following symptoms: hot flashes, night sweats, sleep problems, vaginal dryness, depression, trouble concentrating or remembering things. Eating a healthy diet, exercising regularly, and having a regular sleep schedule can help.

If your menopause symptoms really bother you, talk to your healthcare provider. You should also see a healthcare provider if you experience any bleeding during menopause.

Premera covers office visits and FDA approved medications for menopause treatment. Tests or services that are diagnostic or used to monitor and treat existing medical conditions are included under your health plan, but not free—you will be charged for deductibles, copays, or coinsurance.

Certain HIV Preexposure Prophylaxis (PrEP) medication is covered at no cost when used as a preventive measure for those identified as high risk for HIV infection. Emtricitabine-tenofovir disoproxil is considered preventive when used for HIV PrEP. Descovy and Truvada are considered preventive when used for HIV PrEP and you have tried emtricitabine-tenofovir disoproxil in the last 2 years.