HIV Preventative Service Coverage Tables

For Health Care Providers

July 27, 2026

The Affordable Care Act (ACA) includes several provisions aimed at improving coverage of, and access to, certain HIV preventive health services. These services and the health insurance plans that cover them without cost-sharing are summarized here in these Preventive Services Coverage Tables.

A doctor consults with a patient during an examination.

HIV testing

Recommending Authority	Eligible Populations and Service Specifics	Plans That Cover Without Cost-Sharing
USPSTF (Grade “A”, June 2019)	Screen for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk should also be screened. Screen all pregnant women for HIV, including those who present in labor who are untested and whose HIV status is unknown.1 (See Human Immunodeficiency Virus (HIV) Infection: Screening for additional information.)	Non-grandfathered private health insurance plans Medicare Medicaid expansion plans Traditional Medicaid plans*
Women’s Preventive Services Guidelines (December 2021)	All adolescent and adult women, ages 15 and older, receive a screening test for human immunodeficiency virus (HIV) at least once during their lifetime. Earlier or additional screening should be based on risk, and rescreening annually or more often may be appropriate beginning at age 13 for adolescent and adult women with an increased risk of HIV infection. A screening test for HIV is recommended for all pregnant women upon initiation of prenatal care with rescreening during pregnancy based on risk factors.2 (See Women’s Preventive Service Guidelines for additional information.)	Non-grandfathered private health insurance plans Medicaid expansion plans
Bright Futures/AAP Recommendations for Pediatric Preventive Health Care (December 2024)	Screen adolescents for HIV at least once between the ages of 15 and 21, making every effort to preserve confidentiality of the adolescent, as per “Human Immunodeficiency Virus (HIV) Infection: Screening”. After initial screening, youth at increased risk of HIV infection should be retested annually or more frequently, as per “Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis”.3 (See Recommendations for Preventive Pediatric Health Care for additional information.)	Non-grandfathered private health insurance plans Medicaid expansion plans Traditional Medicaid plans

Recommending Authority

Eligible Populations and Service Specifics

Plans That Cover Without Cost-Sharing

USPSTF (Grade “A”, June 2019)

Screen for HIV infection in adolescents and adults aged 15 to 65 years.

Younger adolescents and older adults who are at increased risk should also be screened.

Screen all pregnant women for HIV, including those who present in labor who are untested and whose HIV status is unknown.1

(See Human Immunodeficiency Virus (HIV) Infection: Screening for additional information.)

Non-grandfathered private health insurance plans

Medicare

Medicaid expansion plans

Traditional Medicaid plans*

Women’s Preventive Services Guidelines (December 2021)

All adolescent and adult women, ages 15 and older, receive a screening test for human immunodeficiency virus (HIV) at least once during their lifetime.

Earlier or additional screening should be based on risk, and rescreening annually or more often may be appropriate beginning at age 13 for adolescent and adult women with an increased risk of HIV infection.

A screening test for HIV is recommended for all pregnant women upon initiation of prenatal care with rescreening during pregnancy based on risk factors.2

(See Women’s Preventive Service Guidelines for additional information.)

Non-grandfathered private health insurance plans

Medicaid expansion plans

Bright Futures/AAP Recommendations for Pediatric Preventive Health Care (December 2024)

Screen adolescents for HIV at least once between the ages of 15 and 21, making every effort to preserve confidentiality of the adolescent, as per “Human Immunodeficiency Virus (HIV) Infection: Screening”.

After initial screening, youth at increased risk of HIV infection should be retested annually or more frequently, as per “Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis”.3

(See Recommendations for Preventive Pediatric Health Care for additional information.)

Non-grandfathered private health insurance plans

Medicaid expansion plans

Traditional Medicaid plans

*Optional for adults, depending on state policy; however, preventive services for children are often covered as part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit for children.

HIV pre-exposure prophylaxis

Recommending Authority	Eligible Populations and Service Specifics	Plans That Cover Without Cost-Sharing
USPSTF (Grade “A”, August 2023)	The USPSTF recommends that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.4 (See Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis for additional information.)	Non-grandfathered private health insurance plans Medicaid expansion plans Traditional Medicaid plans*

Recommending Authority

Eligible Populations and Service Specifics

Plans That Cover Without Cost-Sharing

USPSTF (Grade “A”, August 2023)

The USPSTF recommends that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.4

(See Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis for additional information.)

Non-grandfathered private health insurance plans

Medicaid expansion plans

Traditional Medicaid plans*

Sexually transmitted infection and HIV prevention counseling

Recommending Authority	Eligible Populations and Service Specifics	Plans That Cover Without Cost-Sharing
USPSTF (Grade “B”; August 2020)	Provide behavioral counseling for all sexually active adolescents and for adults who are at increased risk for sexually transmitted infections (STIs). (See Sexually Transmitted Infections: Behavioral Counseling for a discussion of risk factors.)	Non-grandfathered private health insurance plans Medicare Medicaid expansion plans Traditional Medicaid plans*
Women’s Preventive Services Guidelines (November 2021)	Behavioral counseling by a health care clinician or other appropriately trained individual for sexually active adolescent and adult women at an increased risk for sexually transmitted infections (STIs). (See Women’s Preventive Services Guidelines for additional information.)	Non-grandfathered private health insurance plans Medicaid expansion plans

Recommending Authority

Eligible Populations and Service Specifics

Plans That Cover Without Cost-Sharing

USPSTF (Grade “B”; August 2020)

Provide behavioral counseling for all sexually active adolescents and for adults who are at increased risk for sexually transmitted infections (STIs).

(See Sexually Transmitted Infections: Behavioral Counseling for a discussion of risk factors.)

Non-grandfathered private health insurance plans

Medicare

Medicaid expansion plans

Traditional Medicaid plans*

Women’s Preventive Services Guidelines (November 2021)

Behavioral counseling by a health care clinician or other appropriately trained individual for sexually active adolescent and adult women at an increased risk for sexually transmitted infections (STIs).

(See Women’s Preventive Services Guidelines for additional information.)

Non-grandfathered private health insurance plans

Medicaid expansion plans