The Affordable Care Act (ACA) requires new private health insurance plans to cover many recommended preventive services without any patient cost-sharing. For adults, the required services are recommended by the U.S. Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), and the Health Resources and Services Administration (HRSA) based on recommendations issued by the Women’s Preventive Services Initiative. As new recommendations are issued or updated, coverage must commence in the next plan year that begins on or after exactly one year from the recommendation’s issue date.
This tracker presents information on preventive services recommended for adults, by condition, including a summary of the recommendation, the target population, the effective date of coverage, and related federal coverage clarifications. As a result of a district court ruling in the case, Braidwood Management Inc. v. Becerra, the federal government cannot require health plans to cover services recommended or updated by the USPSTF on or after March 23, 2010. This tracker includes all current USPSTF recommendations and will be updated after a final ruling in the case. However, all nongrandfathered plans must continue to cover all preventive services that are recommended by HRSA and ACIP.
For more information, see the fact sheet Preventive Services Covered by Private Health Plans under the Affordable Care Act.