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Preventive Services Covered by Private Health Plans under the Affordable Care Act

The Affordable Care Act created new requirements that private insurers cover preventive services, including routine immunizations, screenings for conditions such as cancer and high cholesterol, and preventive services for women. This fact sheet outlines these prevention requirements and discusses the impact they may have.

Under the ACA, private health plans – other than those that were in existence prior to March 23, 2010 and have “grandfathered” status – must provide coverage for a range of preventive services and may not charge any copayments, deductibles, or co-insurance to patients receiving these services. The majority of the preventive care requirements went into effect for non-grandfathered plans beginning on September 23, 2010; starting August 1, 2012, non-grandfathered insurance plans will be required to cover the additional services recommended for women’s preventive care. The fact sheet examines which types of preventive services must be offered to individuals in general and which preventive services must be offered to special populations such as children, youth and women. A table is also available with a summary of federally-recommended preventive services.

Fact Sheet (.pdf)