The Affordable Care Act (ACA) requires non-grandfathered group health plans (and insurers) to provide coverage for certain preventive health services for all adults, women, and children. Preventive services covered under the law must be provided to individuals without cost sharing, i.e., without the requirement to pay a copayment, coinsurance, deductible, or other cost.
To address scientific advancements and gaps in care identified through clinical practice, the recommended preventive services guidelines for women were updated in December 2021 and are applicable for plans years beginning on or after December 30, 2022. The updated guidelines expand on women’s preventive care services required under five categories: Breastfeeding Services and Supplies, Contraception, Counseling for Sexually Transmitted Infections, Screening for Human Immunodeficiency Virus Infection (HIV), and Well-Women Preventive Visits. In addition, a new preventive service for obesity prevention in midlife women has been added.
Updated Guidelines
- Breastfeeding Services and Supplies: Provides additional information on what breastfeeding equipment and supplies include.
- Contraception: Expands the definition of contraceptive care and updates contraceptives to include all current contraceptives listed in the FDA’s Birth Control Guide.
- Counseling for Sexually Transmitted Infections (STIs): Updated to reflect that clinicians “review” instead of “use” a woman’s sexual history and risk factors to help identify those who are at an increased risk of sexually transmitted infections.
- Screening for Human Immunodeficiency Virus Infection (HIV): Specifies that all adolescents and adult women age 15 and older should receive an HIV screening test at least once during their lifetime and indicates that additional screening, beginning as early as 13 years of age, may be appropriate based on risk factors.
- Well-Women Preventive Visits: Acknowledges that well-women services may take place in a single visit or as part of a series of visits depending on factors such as age, health status, pregnancy status, and other factors.
New Guideline
Obesity Prevention in Midlife Women: This guideline adds counseling services for women between the ages of 40 and 60 with normal to overweight body mass index (BMI) to discuss weight maintenance and obesity prevention.
For a more detailed side-by-side comparison of the current and updated guidance beginning in 2023, see the HRSA-Supported Women's Preventive Services Guidelines: New and Updated Guidelines chart. This webpage also provides a summary of the existing women’s preventive services guidelines that were not updated with the latest guidance.