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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 the following cancer-related screening tests: mammograms, preventive medications and genetic counseling for breast cancer, colonoscopies for colon cancer screening, pap tests for detection of cervical cancer, CT test to screen for lung cancer, and behavioral counseling on skin cancer.
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 cancer-related screening and preventive services covered under the ACA for adults, 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.