Coverage of Preventive Services for Adults in Medicaid

This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to cover such services for adults. The Affordable Care Act (ACA) provides states the opportunity to earn a one percentage point increase in their federal matching rate starting January 1, 2013 if they cover recommended immunizations and preventive services without charging beneficiaries cost-sharing for these services. The survey, fielded by KCMU and Health Management Associates, found that preventive services were generally well-covered by state Medicaid programs in 2010. While there was some variation in which services were covered, each preventive service was covered by at least half if not two-thirds of states.

Issue Brief (.pdf)

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