Preventive Services Covered at $0 (USPSTF and HRSA Women's Lists)
The preventive care a private plan must cover at no cost.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Age in years
- 52
- Sex at birth
- Female
- Pregnant or postpartum
- No
- Coverage
- Private plan, not grandfathered (job-based or Marketplace)
- The date the plan year starts
- 2027-01-01
Result: Example: the USPSTF recommendations and HRSA women's guidelines her plan must cover at no cost, and the ones that depend on an answer.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Coverage
- The date the plan year starts (YYYY-MM-DD)
- Age in years
- Sex at birth
- Pregnant or postpartum
- Have they ever smoked?
- Are they at high risk for preeclampsia?
- Do they have a personal or family history of breast, ovarian, tubal or peritoneal cancer, or an ancestry associated with BRCA1/2 gene mutations?
The other 28 fields
- Are they at increased risk for breast cancer?
- Are they sexually active and 24 or younger, or 25 or older and at increased risk for infection?
- Do they live in the community and are they at increased risk for falls?
- Do they plan to, or could they, become pregnant?
- Do they have cardiovascular disease risk factors?
- Are they at increased risk for hepatitis B infection?
- Is their BMI at or above the 95th percentile for age and sex?
- Are they of reproductive age?
- Are they at increased risk of latent tuberculosis infection?
- Do they have a 20 pack-year smoking history, and currently smoke or quit within the past 15 years?
- Are they postmenopausal with 1 or more risk factors for osteoporosis?
- Are they at increased risk of perinatal depression?
- Do they have overweight or obesity?
- Are they at increased risk of HIV?
- Is their water supply deficient in fluoride?
- Are they Rh(D)-negative and unsensitized?
- Are they a sexually active adolescent, or an adult at increased risk for sexually transmitted infections?
- Do they have a fair skin type?
- Do they have 1 or more cardiovascular risk factors and an estimated 10-year cardiovascular disease risk of 10% or greater?
- Are they at increased risk for syphilis infection?
- Are they a school-aged child or adolescent who has not started to use tobacco?
- Is their BMI 30 or higher?
- Are they an adolescent or an adult (not a younger child)?
- Are they sexually active and at increased risk for STIs (for example younger than 25, a recent STI, a new partner or more than one)?
- Have they had gestational diabetes, and never been diagnosed with type 2 diabetes?
- Is their BMI between 18.5 and 29.9 (normal or overweight)?
- Are they at average risk for cervical cancer?
- Are they due for breast or cervical cancer screening, or for follow-up after one?
How this is calculated
Citation
45 CFR 147.130(a)(1)(i), (a)(1)(iv) and (b)(1): USPSTF A and B items and the HRSA-supported women's guidelines, covered without cost sharing in network for plan years beginning one year after issue; the USPSTF A and B list (verbatim) and HRSA's guidelines page. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.