July 21, 2010
The Obama administration has released key information about the recently enacted Affordable Care Act's (ACA) coverage of preventive services, including STD screenings. New insurance plans cannot charge consumers copayments or deductibles for services with the highest recommendation from the US Preventive Services Task Force (USPSTF).
Only people in plans beginning after Sept. 23, or in existing plans that change substantially, will be covered for discounted services. Employer-based plans not significantly changed would be grandfathered-in.
HIV screening is covered for all adolescents and adults at increased risk for infection. Additional USPSTF clinical considerations specify that people who request HIV screening "despite reporting no individual risk factors may also be considered at increased risk, since this group is likely to include individuals not willing to disclose high-risk behaviors." CDC recommends health care providers routinely offer opt-out HIV screening to all patients ages 13-64.
Other preventive services covered for all adults at higher risk include syphilis screening and STD prevention counseling. The plans will be required to cover immunizations recommended for children and adults, including hepatitis A and B and human papillomavirus.
Cervical cancer screening will be covered for sexually active women, and younger women and women at higher risk are covered for chlamydia testing. Women at increased risk can obtain gonorrhea screening. Pregnant women can obtain hepatitis B and syphilis screening.
Testing and counseling for STDs, including HIV, and TB screening for children and adolescents at increased risk are covered.
Out-of-network charges and the cost of treating an underlying condition could still apply. Consumers also could be charged if the preventive service is not billed separately from another service.
For more information about the ACA and prevention services, visit www.healthcare.gov.