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Prevention of HIV/AIDS, Viral Hepatitis, STDs, and TB Through Health Care

HIV/AIDS, Viral Hepatitis, STD, and TB Preventive Services Covered Without Cost-Sharing Tables

The Affordable Care Act requires coverage of recommended preventive services without cost-sharing for the following health plans:

  1. Non-grandfathered private health insurance plans – Most private insurance plans, including all plans on the Health Insurance Marketplace, and all group or individual health insurance plans that did not exist on March 23, 2010 or that have made significant changes to benefits, cost-sharing, or limits since that time are required to cover services without cost-sharing.1
  2. Medicare - All USPSTF-recommended services that have a Grade “A” or “B” and that are covered by Medicare must be covered without cost-sharing.2
  3. Medicaid expansion plans in states that expand (i.e. Alternative Benefit Plans) – Medicaid expansion plans offered by states that extend Medicaid eligibility to non-elderly individuals with annual incomes at or below 133 percent of the federal poverty level ($15,521 for an individual or $31,720 for a family of 4 in 2014) are required to cover services without cost-sharing.2, 3
  4. Traditional Medicaid plans – Those states that, at their option, cover without cost-sharing in their standard Medicaid benefit package all USPSTF-recommended services that have a Grade “A” or “B” and all ACIP-recommended vaccines receive an increase in their federal medical assistance for such services and vaccines.5

To increase awareness of this no-cost benefit and support the provision of these services, detailed information is provided in the following tables:

For more information on the HIV/AIDS, viral hepatitis, STD, and TB preventive services covered without cost-sharing, see Health Departments: Preventive Service Coverage.



1 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, §1001, 124 Stat. 119, 131 (2010). Available at: http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf
2 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, §4104, 124 Stat. 125, 557-558 (2010). Available at: http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf
3 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, §2001, 124 Stat. 121, 271-272 (2010). Available at: http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf
4 Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment. 78 FR 42159; 42224-42226. Issued 2013 July 15. Accessed 2013 October 31. Available at: http://www.gpo.gov/fdsys/pkg/FR-2013-07-15/pdf/2013-16271.pdf
5 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, §4106, 124 Stat. 125, 559-560 (2010). Available at: http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf

 
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The NCHHSTP Atlas is an interactive tool that provides CDC an effective way to disseminate HIV, Viral Hepatitis, STD and TB data, while allowing users to observe trends and patterns by creating detailed reports, maps, and other graphics. Find out more! http://www.cdc.gov/nchhstp/atlas/


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