On June 11, 2019, the The United States Preventive Services Task Force (USPTF) added pre-exposure prophylaxis (“PrEP”) for persons at high risk of HIV acquisition as a “preventive care” service health plans must provide.
Under the ACA, non-grandfathered health plans are required to provide coverage for preventive care at 100% without cost sharing. Health plans must begin covering PrEP medications on the first day of the plan year beginning one year after the date the USPSTF adopts a recommendation.
USPSTF is charged with determining what services are considered preventive care. They may revise the list of services from time to time. USPSTF’s recommendation details which individuals are considered “at high risk of HIV” acquisition.
