Preventive Service Coverage

On June 27, 2025, the United States Supreme Court issued its decision to uphold the constitutionality of the U.S. Preventive Services Task Force (USPSTF), meaning that insurers remain required by federal law to cover USPSTF recommendations. Click here to read more.

The Patient Protection and Affordable Care Act (ACA) now requires qualified health plans to cover PrEP as a preventive service at no cost to the patient. Most private insurance plans must provide $0 cost-sharing for at least one PrEP product, so most patients should not need copay assistance programs.

Verifying PrEP Medication Coverage Infographic: This infographic summarizes the steps to verify that a given plan is offering PrEP at no cost to the patient. Visit healthcare.gov/see-plans to get started, or visit your state-based marketplace.

NASTAD PrEP Coverage Brief: PrEP Services Covered with No Cost-Sharing: This fact sheet walks through the coverage and cost-sharing requirements for public and private payers that come with this USPSTF Grade A recommendation. It summarizes federal guidance on implementing Preventive Services provisions of the Affordable Care Act (ACA), including new federal sub-regulatory guidance addressing PrEP services released on July 19, 2021.

PrEP Cost Sharing Complaint Template: The PrEP Cost Sharing Complaint Template is meant to assist providers and patients file a complaint about an uncompliant health plan charging for PrEP services.