TABLES: Reproductive and Sexual Health Benefits in Private Health Insurance Plans in Washington State

	Family Planning Perspectives Volume 33, Number 4, July/August 2001
	Reproductive and Sexual Health Benefits in Private Health Insurance Plans in Washington State TABLES

Table 1. Number and percentage distribution of health insurance plans and total number of enrollees, all by type of plan, Washington State, 1998
Type	Plans		Enrollees
Type	No.	% distribution	No.	% distribution
Total	91	100	1,399,650	100
HMO	52	57	977,813	70
Preferred-provider org.	19	21	245,231	18
Point-of-service	13	14	127,379	9
Indemnity	7	8	49,227	3

Table 2. Percentage of Washington State health insurance plans offering core reproductive and sexual health care coverage, by type of service, according to plan type
Service	HMO	Point-of-service	Preferred-organization	Indemnity
Routine gynecology	96	100	72	100
Maternity	93	92	94	86
Contraception	50	15	6	0
Abortion (elective)	76	85	67	86
Infertility	20	8	28	86
Reproductive cancer screening	100	100	94	100
Sexually transmitted diseases	100	100	94	100
HIV/AIDS	100	100	100	100
Sterilization	80	83	65	71

Table 3. Estimated number of age-specific enrollees in all health plans, number of age-specific enrollees in health plans providing core coverage, and number and percentage of all age-specific enrollees lacking core service coverage
Service	No. in all plans	No. in plans providing core coverage	Lacking core coverage
Service	No. in all plans	No. in plans providing core coverage	No.	%
Routine gynecology	270,138†	235,475	34,663	12.8
Maternity	258,774†	210,761	48,013	18.6
Contraception	255,244†	63,381	191,863	75.2
Abortion	269,955†	127,002	142,993	52.9
Infertility	524,805‡	11,116	513,689	97.9
Reproductive cancer screening	949,647§	901,767	47,880	5.0
Sexually transmitted diseases	949,647§	901,767	47,880	5.0
HIV/AIDS	949,647§	949,647	0	0.0
Sterilization	522,236‡	328,979	193,257	37.0
†Women aged 15-44. ‡Women and men aged 15-44. §Women and men aged >=15. Note: Numbers of women and men in each age category were estimated by applying adjusted statewide age categories to total reported numbers of enrollees.

Table 4. Percentage of health insurance plans with routine plus restricted coverage, by service, according to plan type, United States (1993) and Washington State (1998)
Service	Indemnity plan†		Preferred-provider organization†		Point-of-service plan		HMO†
Service	U.S.	WA	U.S.	WA	U.S.	WA	U.S.	WA
Gynecology
Annual exam	48	100**	68	72	90	100	100	96*
Pap test	76	100	86	72	95	100	100	96*
Chlamydia test	78	100	85	72	100	100	100	96*
Mammogram	84	100	90	100	95	100	100	100
Maternity care
Obstetric care	96	86	99	94	95	92	99	100
Reversible contraception
IUD insertion	25	0	25	6	46	62	86	70*
IUD device	17	0	21	6	33	62	47	70*
Diaphragm fitting	21	0	23	6	46	46	81	68
Diaphragm device	15	0	17	6	33	38	52	70*
Implant insertion	26	0	29	6*	54	38	62	52
Implant device	23	0	27	6	48	31	47	52
Implant removal	36	0	37	11*	59	46	65	52
Injectable	41	0*	42	6**	75	62	80	59*
Oral contraceptives	41	0*	48	11**	63	92*	86	84
Sterilization
Tubal ligation	90	86	90	88	98	83	94	84*
Vasectomy	89	86	90	88	95	83	94	84*
Abortion
Average availability	87	93	86	83	88	92	90	88
Infertility
Endometrial biopsy	80	86	79	50*	81	77	94	51***
Semen analysis	64	14*	60	44	71	46	95	27***
In vitro fertilization	16	0	17	0	19	0	24	0***
Medication	45	14	45	28	51	8**	75	24***
Difference is statistically significant, X²p<.05. **Difference is statistically significant, X²p<.001. †Washingtion coverage is significantly lower than U.S. coverage, p<.001 (odds ratio 0.55, 95% confidence interval 0.48--0.63). Source: U.S.Data (1993) --see reference 16.