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Chronic Condition Preventive Health Services for Adults Covered by the ACA
Published: September 25, 2024
The Affordable Care Act (ACA) requires most private health insurance plans and Medicaid ACA expansion programs to cover many recommended preventive services without any patient cost-sharing, including services for prevention and early detection of risks associated with chronic conditions, such as heart disease, diabetes, obesity, hepatitis, anxiety, and depression.
The required services for adults are recommended by the U.S. Preventive Services Task Force (USPSTF)and the Health Resources and Services Administration (HRSA) based on recommendations issued by the Women’s Preventive Services Initiative. The Advisory Committee on Immunization Practices recommends vaccines for adults and children that must also be covered without cost-sharing.
The table below presents detailed information on preventive health services related to chronic conditions for adults covered under the ACA, including a summary of the recommendation, the target population, effective date of coverage, and related coverage clarifications. Ongoing litigation over the scope of the preventive services requirement in the case, Braidwood Management Inc. v. Becerra, could affect coverage policy of preventive health services in the future.