STD Preventive Service Coverage Tables

At a glance

The Affordable Care Act (ACA) includes several provisions aimed at improving coverage of, and access to, certain STD 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.

An STD doctor advises a male patient.

Chlamydia testing

Recommending Authority Eligible Populations and Service Specifics Plans That Cover Without Cost-Sharing
USPSTF (Grade “B”, September 2021) Screen the following groups for chlamydia:
  • Sexually active women (including pregnant women) age 24 years and younger
  • Sexually active older women (including pregnant women) who are at increased risk for chlamydia infection1
(See Chlamydia and Gonorrhea: Screening  for additional information.)

Non-grandfathered private health insurance plans

Medicare

Medicaid expansion plans

Traditional Medicaid plans*
Bright Futures/AAP Recommendations for Pediatric Preventive Health Care (March 2020) Screen all adolescents between the ages 11 and 21 according to recommendations in the current edition of the AAP Red Book: Report of the Committee on Infectious Diseases. These include at least annual screening for:
  • All sexually active girls and young women
  • Sexually active boys and young men who are at increased risk for infection (e.g., men who have sex with men)2
(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.

Syphilis testing

Recommending Authority Eligible Populations and Service Specifics Plans That Cover Without Cost-Sharing
USPSTF (Grade “A”; September 2022) Screen nonpregnant adolescents and adults at increased risk for syphilis infection.3

(See Syphilis Infection in Nonpregnant Adolescents and Adults: Screening for additional information)

Non-grandfathered private health insurance plans

Medicare

Medicaid expansion plans

Traditional Medicaid plans*
USPSTF (Grade “A”, September 2018)

Screen all pregnant women for syphilis infection.4

(See Syphilis Infection in Pregnant Women: Screening for additional information)		 Non-grandfathered private health insurance plans Medicare Medicaid expansion plans Traditional Medicaid plans*
Bright Futures/AAP Recommendations for Pediatric Preventive Health Care (March 2020) Screen sexually active adolescents between the ages 11 and 21 who are at increased risk for infection, in accordance with recommendations in the current edition of the AAP Red Book: Report of the Committee on Infectious Diseases 2 (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.

Gonorrhea testing

Recommending Authority Eligible Populations and Service Specifics Plans That Cover Without Cost-Sharing
USPSTF (Grade “B”; September 2021) Screen the following groups for gonorrhea:
  • Sexually active women (including pregnant women) age 24 years and younger;
  • Sexually active older women (including pregnant women) who are at increased risk for chlamydia infection1
(See Chlamydia and Gonorrhea: Screening for additional information.)

Non-grandfathered private health insurance plans

Medicare

Medicaid expansion plans

Traditional Medicaid plans*
Bright Futures/AAP Recommendations for Pediatric Preventive Health Care (March 2020) Screen all adolescents between the ages 11 and 21 according to recommendations in the current edition of the AAP Red Book: Report of the Committee on Infectious Diseases. These include at least annual screening for:
  • All sexually active girls and young women
  • Sexually active boys and young men who are at increased risk for infection (e.g., men who have sex with men)2
(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.

Ocular prophylaxis for gonococcal ophthalmia neonatorum

Recommending Authority Eligible Populations and Service Specifics Plans That Cover Without Cost-Sharing
USPSTF (Grade “A”; January 2019) Provide prophylactic ocular topical medication to all newborns for the prevention of gonococcal ophthalmia neonatorum.5

(See Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: Preventive Medication 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.

Human papillomavirus: testing

Recommending Authority Eligible Populations and Service Specifics Plans That Cover Without Cost-Sharing
Women’s Preventive Services Guidelines (December 2016) Screen average-risk women aged 21 to 65 years for cervical cancer.
  • For women aged 21 to 29 years, using cervical cytology (Pap test) every 3 years.
  • Women aged 30 to 65 years should be screened with cytology and human papillomavirus testing every 5 years or cytology alone every 3 years.6
(See Women’s Preventive Services Guidelines for additional information.)

Non-grandfathered private health insurance plans

Medicaid expansion plans
USPSTF (Grade “A”; August 2018) Screen women ages 21 to 65 for cervical cancer. Age 21–29:
  • Every 3 years with cervical cytology testing
Age 30–65:
  • Every 3 years with cervical cytology testing
  • OR every 5 years with high-risk human papillomavirus testing (hrHPV)
  • OR every 5 years with hrHPV testing in combination with cytology testing (co-testing).7
(See Cervical Cancer: Screening for additional information)

Non-grandfathered private health insurance plans

Medicare

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.

Human papillomavirus: vaccination

Recommending Authority Eligible Populations and Service Specifics Plans That Cover Without Cost-Sharing
ACIP (August 2019) Vaccination against human papillomavirus (HPV) is routinely recommended at age 11 or 12 years.
  • For persons initiating vaccination before their 15th birthday, the recommended immunization schedule is 2 doses of HPV vaccine.
  • For persons initiating vaccination on or after their 15th birthday, or for persons with certain immunocompromising conditions, the recommended immunization schedule is 3 doses of HPV vaccine.8
(See Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices for additional details)

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.

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 intensive behavioral counseling to prevent sexually transmitted infections (STIs) to all sexually active adolescents and for adults at increased risk for STIs.9

(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 (December 2016) Provide counseling on sexually transmitted infections, including HIV, for all sexually active women.6

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

Non-grandfathered private health insurance plans

Medicaid expansion 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.

Preventive services coverage

Review provision summaries by market segment.

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Content Source:
National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention
  1. Chlamydia and Gonorrhea: Screening; U.S. Preventive Services Task Force. September 2021.
  2. Bright Futures/AAP Recommendations for Pediatric Preventive Health Care; American Academy of Pediatrics. March 2020.
  3. Syphilis Infection in Nonpregnant Adults and Adolescents: Screening; U.S. Preventive Services Task Force. September 2022.
  4. Syphilis Infection in Pregnant Women: Screening; U.S. Preventive Services Task Force. September 2018.
  5. Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: Preventive Medication; U.S. Preventive Services Task Force. January 2019.
  6. Women's Preventive Services Guidelines; Health Resources and Services Administration. December 2016.
  7. Cervical Cancer: Screening; U.S. Preventive Services Task Force. August 2018.
  8. Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices Centers for Disease Control and Prevention. MMWR 2019; 68(32);698–702.
  9. Sexually Transmitted Infections: Behavioral Counseling; U.S. Preventive Services Task Force. August 2020.