--- kind: "section" citation: "42 U.S.C. § 300gg–13" title: "42" title_heading: "The Public Health and Welfare" number: "300gg–13" heading: "Coverage of preventive health services" release: "119-102" date: "2026-07-12" url: "https://uscodex.org/usc/42/300gg-13" units: - "Chapter 6A — Public Health Service" - "Subchapter XXV — Requirements Relating to Health Insurance Coverage" - "Part A — Individual and Group Market Reforms" - "Subpart II — Improving Coverage" --- # §300gg–13. Coverage of preventive health services - (a) **In general—** A [group health plan](/usc/42/300bb–8.md?p=1) and a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) offering group or [individual health insurance coverage](/usc/42/300gg–91.md?p=b-5) shall, at a minimum provide coverage for and shall not impose any cost sharing requirements for— - (1) evidence-based items or [services](/usc/42/201.md?p=a) that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive [Services](/usc/42/201.md?p=a) [Task Force](/usc/42/242q–4.md?p=3); - (2) immunizations that have in effect a recommendation from the [Advisory Committee](/usc/42/17061.md?p=2) on Immunization [Practices](/usc/42/17061.md?p=19) of the Centers for Disease Control and Prevention with respect to the individual involved; and[^1] - (3) with respect to infants, children, and [adolescents](/usc/42/300z–1.md?p=a-9), evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and [Services](/usc/42/201.md?p=a) Administration.[^1] - (4) with respect to women, such additional preventive care and screenings not described in [paragraph (1)](#a-1) as provided for in comprehensive guidelines supported by the Health Resources and [Services](/usc/42/201.md?p=a) Administration for purposes of this paragraph.[^1] - (5) for the purposes of this chapter, and for the purposes of any other provision of law, the current recommendations of the United States Preventive [Service](/usc/42/201.md?p=a) [Task Force](/usc/42/242q–4.md?p=3) regarding breast cancer screening, mammography, and prevention shall be considered the most current other than those issued in or around November 2009. Nothing in this subsection shall be construed to prohibit a plan or issuer from providing coverage for [services](/usc/42/201.md?p=a) in addition to those recommended by United States Preventive [Services](/usc/42/201.md?p=a) [Task Force](/usc/42/242q–4.md?p=3) or to deny coverage for [services](/usc/42/201.md?p=a) that are not recommended by such [Task Force](/usc/42/242q–4.md?p=3). - (b) **Interval—** - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) shall establish a minimum interval between the date on which a recommendation described in subsection [(a)(1)](#a-1) or [(a)(2)](#a-2) or a guideline under [subsection (a)(3)](#a-3) is issued and the plan year with respect to which the requirement described in [subsection (a)](#a) is effective with respect to the [service](/usc/42/201.md?p=a) described in such recommendation or guideline. - (2) **Minimum—** The interval described in [paragraph (1)](#b-1) shall not be less than 1 year. - (c) **Value-based insurance design—** The [Secretary](/usc/42/201.md?p=c) may develop guidelines to permit a [group health plan](/usc/42/300bb–8.md?p=1) and a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) offering group or [individual health insurance coverage](/usc/42/300gg–91.md?p=b-5) to utilize value-based insurance designs. ## Footnotes [^1]: So in original. ## Source credit (July 1, 1944, ch. 373, title XXVII, § 2713, as added Pub. L. 111–148, title I, § 1001(5), Mar. 23, 2010, 124 Stat. 131.) ## Notes ### Editorial Notes ### Prior Provisions A prior section 300gg–13, act July 1, 1944, ch. 373, title XXVII, § 2713, as added Pub. L. 104–191, title I, § 102(a), Aug. 21, 1996, 110 Stat. 1966, was renumbered section 2709 of act July 1, 1944, and transferred to section 300gg–9 of this title by Pub. L. 111–148, title I, §§ 1001(3), 1563(c)(10)(C), formerly § 1562(c)(10)(C), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 268, 911. Another prior section 2713 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see section 238l of this title. ### Statutory Notes and Related Subsidiaries ### Effective Date Section effective for plan years beginning on or after the date that is 6 months after Mar. 23, 2010, see section 1004 of Pub. L. 111–148, set out as a note under section 300gg–11 of this title. ### Rapid Coverage of Preventive Services and Vaccines for Coronavirus Pub. L. 116–136, div. A, title III, § 3203, Mar. 27, 2020, 134 Stat. 367, provided that: In General.—Notwithstanding [section] 2713(b) of the Public Health Service Act (42 U.S.C. 300gg–13[(b)]), the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury shall require group health plans and health insurance issuers offering group or individual health insurance to cover (without cost-sharing) any qualifying coronavirus preventive service, pursuant to section 2713(a) of the Public Health Service Act (42 U.S.C. 300gg–13(a)) (including the regulations under sections 2590.715–2713 of title 29, Code of Federal Regulations, section 54.9815–2713 of title 26, Code of Federal Regulations, and section 147.130 of title 45, Code of Federal Regulations (or any successor regulations)). The requirement described in this subsection shall take effect with respect to a qualifying coronavirus preventive service on the specified date described in subsection (b)(2). Definitions.—For purposes of this section: Qualifying coronavirus preventive service.—The term ‘qualifying coronavirus preventive service’ means an item, service, or immunization that is intended to prevent or mitigate coronavirus disease 2019 and that is— an evidence-based item or service that has in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force; or an immunization that has in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved. Specified date.—The term ‘specified date’ means the date that is 15 business days after the date on which a recommendation is made relating to the qualifying coronavirus preventive service as described in such paragraph. Additional terms.—In this section, the terms ‘group health plan’, ‘health insurance issuer’, ‘group health insurance coverage’, and ‘individual health insurance coverage’ have the meanings given such terms in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91), section 733 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1191b), and section 9832 of the Internal Revenue Code [26 U.S.C. 9832], as applicable.”