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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 pregnancy-related services and supports such as: prenatal visits, folic acid, anxiety and depression screenings, screenings and medication for preeclampsia, STI tests, smoking cessation support, and breastfeeding and lactation counseling and supplies.
The required services 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 pregnancy-related preventive services 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, which could affect coverage policy for clinical preventive services in the future.