At a glance
The Affordable Care Act (ACA) includes several provisions aimed at improving coverage of, and access to, certain viral hepatitis 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.
Hepatitis A: vaccination
| Recommending Authority | Eligible Populations and Service Specifics | Plans That Cover Without Cost-Sharing |
|---|---|---|
| ACIP (May 2006 and February 2019) | Routine vaccination is recommended for the following groups for hepatitis A (HAV) immunization: children, persons who are at increased risk for infection, all persons experiencing homelessness, and any person wishing to obtain immunity.1,2
(See Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) - PubMed (nih.gov) and MMWR: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness for additional information.) |
Non-grandfathered private health insurance plans Medicaid expansion plans Traditional Medicaid plans* |
| ACIP (November 2018) |
Hepatitis A vaccine for postexposure prophylaxis is recommended to all persons aged ≥12 months. Hepatitis A vaccine for preexposure prophylaxis is recommended for unvaccinated persons traveling to or working in countries that have high or intermediate HAV endemicity.3 (See MMWR: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel 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.
Hepatitis B: vaccination
| Recommending Authority | Eligible Populations and Service Specifics | Plans That Cover Without Cost-Sharing |
|---|---|---|
| ACIP (January 2018) | Vaccinate the following populations for hepatitis B (HBV):
|
Non-grandfathered private health insurance plans Medicaid expansion plans Traditional Medicaid plans* |
^See MMWR Box 4 for specific information on persons at risk for hepatitis B.
*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.
Hepatitis B: testing
| Recommending Authority | Eligible Populations and Service Specifics | Plans That Cover Without Cost-Sharing |
|---|---|---|
| USPSTF (Grade “A”; July 2019) | Screen pregnant women for hepatitis B virus infection at their first prenatal visit.6
(See Hepatitis B Virus Infection in Pregnant Women: Screening for additional information.) |
Non-grandfathered private health insurance plans Medicaid expansion plans Traditional Medicaid plans** |
| USPSTF (Grade “B”; December 2020) | Screen for hepatitis B virus (HBV) infection in adolescents and adults at increased risk for infection.**
(See Hepatitis B Virus Infection: Screening, 2020 and Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023* for additional information.) |
Non-grandfathered private health insurance plans Medicaid expansion plans Traditional Medicaid plans** |
| Bright Futures/AAP Recommendations for Pediatric Preventive Health Care (December 2024) | Perform a risk assessment for hepatitis B virus (HBV) infection according to recommendations per the USPSTF and in the 2021–2024 edition of the AAP Red Book: Report of the Committee on Infectious Diseases.
(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.
**In 2023 CDC published updated recommendations among adults for hepatitis B screening and testing. CDC recommends screening all adults aged 18 and older for hepatitis B at least once in their lifetime.
Hepatitis C: testing
| Recommending Authority | Eligible Populations and Service Specifics | Plans That Cover Without Cost-Sharing |
|---|---|---|
| USPSTF (Grade “B”; March 2020) | Screen for hepatitis C virus infection in adults ages 18 to 79 years.7
(See Hepatitis C Virus Infection in Adolescents and Adults: 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 (December 2024) | All individuals should be screened for hepatitis C virus (HCV) infection according to the USPSTF and CDC recommendations at least once between the ages of 18 and 79.
Those at increased risk of HCV infection, including those who are persons with past or current injection drug use, should be tested for HCV infection and reassessed annually. (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.
- Prevention of Hepatitis A Through Active or Passive Immunization. Centers for Disease Control and Prevention. MMWR 2006; 55(RR07);1-23.
- Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness. Centers for Disease Control and Prevention. MMWR 2019; 68:153–156.
- Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel. Centers for Disease Control and Prevention. MMWR 2018; 67:1216–1220.
- Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. Centers for Disease Control and Prevention. MMWR 2018 (RR-1): 1–31.
- Recommendations of the Advisory Committee on Immunization Practices for Use of a Hepatitis B Vaccine with a Novel Adjuvant. Centers for Disease Control and Prevention. MMWR 2018; 67:455–458.
- Hepatitis B Virus Infection in Pregnant Women: Screening; U.S. Preventive Services Task Force. July 2019.
- Hepatitis C Virus Infection in Adolescents and Adults: Screening; U.S. Preventive Services Task Force. March 2020.
- Hepatitis B Virus Infection: Screening, 2014; U.S. Preventive Services Task Force. June 2014.