Enrollment and Coverage of Preventive Services in Expanded Medicaid

ACA Reference Guide May 2014

 Cancer screenings and other preventive services covered without cost-sharing in expanded Medicaid for adult women1:

o Graded A or B USPSTF clinical preventive services: These include cervical, breast, and colorectal cancer screening for age-appropriate groups as well as breast cancer preventive medications and BRCA risk assessment and genetic counseling/testing.

o Preventive services supported by the Health Resources and Services Administration (HRSA): These include at least one well-woman preventive care visit a year to provide recommended preventive services.

o Immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC)

o A comprehensive list with all covered preventive services described above can be found at healthcare.gov. This resource provides information for women in plain language, directs them to other sources of related information, and includes lists with questions that women can bring to medical appointments to discuss with their doctors.

 Applying for health coverage in expanded Medicaid: This resource allows you to learn 1) which states are expanding Medicaid, 2) how to apply for Medicaid coverage, and 3) information on other insurance affordability options for those who do not qualify for Medicaid, such as cost- sharing reductions and advance premium tax credits.

 How is Medicaid eligibility determined in states expanding Medicaid? Whether an individual qualifies for Medicaid coverage in states expanding Medicaid is determined by income and family size. This resource provides a chart with information on who qualifies for Medicaid coverage based on different combinations of an individual’s income and his or her family size.

 Where can individuals sign up for Medicaid coverage? An individual can sign up for Medicaid coverage all year round by either filling out an application through the marketplace or contacting their state Medicaid program directly. This resource directs you to the portal to sign up for Medicaid coverage through the marketplace.

1 These services must also be covered without cost-sharing by qualified health plans offered in the health insurance marketplace.