Updated Coverage for Mandated Preventive Care Services

Non-grandfathered health plans must provide coverage for certain recommended preventive care services with no cost sharing applied to participants. The recommendations are issued by the United States Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP) of the CDC, and the Health Resources and Services Administration (HRSA). Group health plans must provide coverage for a new recommendation for plan years starting one year after it’s issued.

Below is a listing of the preventive care services that have been newly recommended since March 2018 along with the effective date (plans must comply for plan years starting on or after the indicated date).

  • Skin cancer counseling about minimizing exposure to ultraviolet radiation for persons aged 6 months to 24 years with fair skin and their parents: March 1, 2019.
  • Osteoporosis screening using bone measurement testing for women aged 65 and older with screening for postmenopausal women younger than age 65 who are at increased risk for osteoporosis: June 1, 2019.
  • Exercise intervention to prevent falls in community dwelling adults aged 65 and older who are at increased risk for falls (includes supervised individual/group exercise classes and physical therapy): April 1, 2019.
  • Obesity screening and counseling for adults with a body mass index of 30 or higher: Sept. 1, 2019.
  • Syphilis screening for pregnant women: Sept. 1, 2019.
  • Intimate partner violence screening for women of reproductive age with a referral to support services: Oct. 1, 2019.

USPSTF Recommendations »
ACIP Recommendations »
HRSA Recommendations for Children and Adolescents »
HRSA Recommendations for Women »
HRSA Recommendations for Newborns »