ACA-Covered Preventive Health Services for Women
Most health plans must cover additional preventive health services for women, ensuring a comprehensive set of preventive services to meet women's unique health care needs.
Under the Patient Protection and Affordable Care Act (ACA), preventive services with a U.S. Preventive Services Task Force (USPSTF) grade of A or B must be covered by all Marketplace health plans and many other plans without charging a copayment or coinsurance. This is true even if the yearly deductible hasn't been met.
This applies only when these services are delivered by an in–network provider.
- Anemia screening on a routine basis for pregnant women
- Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer
- Breast Cancer Mammography screenings every 1 to 2 years for women over 40
- Breast Cancer Chemoprevention counseling for women at higher risk
- Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
- Cervical Cancer screening for sexually active women
- Chlamydia Infection screening for younger women and other women at higher risk
- Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt "religious employers."
- Domestic and interpersonal violence screening and counseling for all women
- Folic Acid supplements for women who may become pregnant
- Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
- Gonorrhea screening for all women at higher risk
- Hepatitis B screening for pregnant women at their first prenatal visit
- HIV screening and counseling for sexually active women
- Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older
- Osteoporosis screening for women over age 60 depending on risk factors
- Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
- Sexually Transmitted Infections counseling for sexually active women
- Syphilis screening for all pregnant women or other women at increased risk
- Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
- Urinary tract or other infection screening for pregnant women
- Well-woman visits to get recommended services for women under 65
- ACA Covered Preventive Health Services for Women
- ACA Covered Preventive Health Services for Adults
- ACA Covered Preventive Health Services for Children
Agency for Healthcare Research and Quality. Guide to Clinical Preventive Services: 2014. Available at: http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/preface.html
Healthcare.gov. Preventive care benefits. Available at: https://www.healthcare.gov/what-are-my-preventive-care-benefits/
U.S. Preventive Services Task Force. Available at: http://www.uspreventiveservicestaskforce.org/
Page originally created April 2015