Which preventive screenings the US Preventive Services Task Force currently recommends at each age, what the letter grades mean for whether your plan must cover them, and the ages at which screening should stop.
If a preventive screening carries a Grade A or Grade B recommendation from the US Preventive Services Task Force, most health plans must cover it with no copayment and no coinsurance. That single rule is the most useful thing to know about preventive care in the United States, because it converts a vague instruction to “get your checkups” into a specific list of things you are already paying for and can claim.
The list changes with age, and it changes in ways that surprise people. Colorectal screening now starts at 45, not 50. Mammography now starts at 40. Diabetes screening stops being recommended at 70. Prostate screening is not recommended at all after 70. Below is what the Task Force currently recommends, organised by the decade you are in, with the grade attached to each so you can tell which ones your plan has to pay for.
What the grades mean, because the letter is the whole point
The Task Force assigns every recommendation a letter, and the letters have precise definitions.
| Grade | What the Task Force means | Practical effect |
|---|---|---|
| A | Recommends the service; high certainty the net benefit is substantial | Offer or provide it |
| B | Recommends the service; net benefit is moderate | Offer or provide it |
| C | Offer selectively, depending on individual circumstances | Requires a conversation, not a default |
| D | Recommends against; no net benefit, or harms outweigh benefits | Discourage it |
| I | Evidence is insufficient to judge benefits against harms | Uncertain; patient should understand that |
The Affordable Care Act ties coverage to those letters. Healthcare.gov states that all Marketplace health plans and many other plans must cover a list of preventive services for adults without a copayment or coinsurance, generally when delivered by an in-network provider, and notes that zero cost is not guaranteed in every case. The named list includes abdominal aortic aneurysm screening, alcohol misuse screening, blood pressure screening, cholesterol screening, colorectal cancer screening, depression screening, type 2 diabetes screening, hepatitis B and hepatitis C screening, HIV screening, lung cancer screening, obesity screening, statin preventive medication, syphilis screening, tobacco use screening and tuberculosis screening, among others.
A Grade C recommendation is a different animal. It is not a weaker version of B. It means the evidence supports offering the service to some people and not others, and it does not carry the same coverage guarantee. Prostate-specific antigen testing is the clearest example, and treating it as a routine annual item is a misreading of what the Task Force actually says.
This structure survived a direct constitutional challenge recently. In Kennedy v. Braidwood Management, decided June 27, 2025, the Supreme Court held 6 to 3 that Task Force members are inferior officers whose appointment by the Secretary of Health and Human Services satisfies the Appointments Clause. The practical consequence is that the link between Task Force grades and mandatory no-cost coverage remains intact. The same opinion also confirms that the Secretary has authority to review and block recommendations before they take effect, which is worth remembering: this list is not fixed by statute, and it can move.
Your twenties and thirties
Most of what belongs here is cheap, fast, and skipped.
Blood pressure, Grade A. The Task Force reaffirmed in 2021 that adults 18 and older should be screened for hypertension, with out-of-office measurement to confirm a diagnosis before treatment starts. The suggested cadence is every three to five years for adults 18 to 39 with previously normal readings and no increased risk, and annually for adults 40 and over or anyone at increased risk. The number itself is worth understanding rather than just recording, which is covered in what the two blood pressure figures actually mean.
Cervical cancer, Grade A. The 2018 recommendation is screening every three years with cytology alone for women aged 21 to 29. The Task Force recommends against screening women younger than 21, a Grade D, which is an active recommendation not to do it rather than an oversight.
Hepatitis C, Grade B. The 2020 recommendation covers all adults aged 18 to 79, replacing the older approach of screening only the 1945 to 1965 birth cohort and high-risk groups. This is one of the most commonly missed items on the list, because most people under 50 assume it does not apply to them.
HIV, Grade A. Recommended for adolescents and adults, with the 2019 statement covering ages 15 to 65.
Depression, Grade B. The 2023 recommendation covers the adult population, including pregnant and postpartum people and older adults. Screening for suicide risk specifically received a Grade I, insufficient evidence, which is a statement about the screening instruments rather than about the seriousness of the problem.
Prediabetes and type 2 diabetes, Grade B, from 35. The 2021 recommendation covers adults aged 35 to 70 who have overweight or obesity, defined as a body mass index of 25 or above, or 30 or above for obesity, with the Task Force noting a threshold of 23 may be appropriate for Asian American adults. Suggested interval is every three years when initial glucose results are normal. The recommendation also asks clinicians to refer people found to have prediabetes to effective preventive interventions, which is the half of the recommendation that most often does not happen.
Your forties
Three significant items begin in this decade, and two of them moved earlier in recent revisions.
Mammography, Grade B, from 40. The 2024 recommendation is biennial screening mammography for women aged 40 to 74. That is a change from the previous framing, which left the forties to individual decision-making. For supplemental imaging with ultrasound or MRI in women with dense breasts, the Task Force issued a Grade I: the evidence is currently insufficient to weigh benefits against harms.
Colorectal cancer, Grade B, from 45. The 2021 recommendation covers adults aged 45 to 49 at Grade B, with a moderate net benefit. This is the change most often missed, because the previous starting age of 50 has been in public consciousness for decades.
Statin assessment, from 40. The 2022 recommendation is Grade B for adults aged 40 to 75 who have at least one cardiovascular risk factor and an estimated 10-year risk of 10 percent or more, and Grade C, selectively offer, for those with a 10-year risk between 7.5 and 10 percent. Risk factors include dyslipidemia, diabetes, hypertension and smoking. Note that the recommendation is about a medication decision driven by a calculated risk score, not about a cholesterol number read in isolation, a distinction explored in how to read a lab panel without panicking.
Cervical cancer screening options widen at 30. For women aged 30 to 65, the Task Force’s Grade A options are cytology every three years, high-risk HPV testing alone every five years, or cotesting every five years.
Your fifties
Colorectal cancer moves to Grade A. For all adults aged 50 to 75, the 2021 recommendation carries the Task Force’s highest grade, substantial net benefit.
Lung cancer, Grade B, if the smoking history fits. The 2021 recommendation is annual low-dose computed tomography for adults aged 50 to 80 with a 20 pack-year smoking history who currently smoke or have quit within the past 15 years. The 2013 version required ages 55 to 80 and 30 pack-years, so a meaningful number of people became eligible without being told. Screening stops after 15 years of abstinence, or when a health condition substantially limits life expectancy or the ability to have surgery.
Prostate cancer, Grade C, from 55. The 2018 recommendation is that PSA-based screening for men aged 55 to 69 should be an individual decision made after discussing benefits and harms. The Task Force’s own figure is that screening may prevent roughly 1.3 prostate cancer deaths per 1,000 men screened over 13 years, against harms including false positives, overdiagnosis, incontinence and erectile dysfunction. That is the trade a Grade C describes, and it is why the letter is C rather than B.
Your sixties
Osteoporosis, Grade B. The January 2025 recommendation covers all women 65 and older, and postmenopausal women younger than 65 who are at increased risk, both at Grade B, using bone mineral density testing with or without a fracture risk assessment tool. For men, the Task Force issued a Grade I.
Abdominal aortic aneurysm, Grade B, one time. The 2019 recommendation is a single ultrasound screening for men aged 65 to 75 who have ever smoked, where ever-smoked means at least 100 cigarettes in a lifetime. For men in that age range who never smoked, the grade is C. For women who never smoked and have no family history, the grade is D. For women 65 to 75 who smoked or have a family history, the grade is I.
Cervical cancer screening can stop at 65, a Grade D, for women who have had adequate prior screening and are not otherwise at high risk. The Task Force also recommends against screening after a hysterectomy with removal of the cervix, absent a history of high-grade lesions or cervical cancer.
Diabetes screening has an upper bound. The Grade B recommendation covers ages 35 to 70. Past 70 it is no longer a graded recommendation, which is not the same as saying it is useless, but it is not covered by the same guarantee.
Seventy and beyond: the stopping ages
This is the part almost no consumer guide covers, and it is arguably the most valuable. Screening tests have harms, and once remaining life expectancy falls below the time a screening-detected cancer would take to cause harm, the arithmetic reverses.
| Service | What happens with age | Grade |
|---|---|---|
| Prostate, PSA | Recommends against, from 70 | D |
| Mammography | Evidence insufficient, 75 and older | I |
| Colorectal cancer | Offer selectively, 76 to 85; not recommended at 86 and over | C |
| Hepatitis C | Recommendation covers up to 79 | B to 79 |
| Lung cancer | Recommendation covers up to 80 | B to 80 |
| Statin, primary prevention | Evidence insufficient, 76 and older | I |
| Cervical cancer | Recommends against after 65 with adequate prior screening | D |
Four of those are explicit instructions to stop or to stop defaulting. A clinician who orders an annual PSA on a 74-year-old is working against the recommendation, not following it.
A decision rule
- Write down your age, your sex, your smoking history in pack-years, and your body mass index. Those four variables determine almost every item above. Without them you cannot tell which list is yours.
- Separate the Grade A and B items from the Grade C items. The first group is what your plan generally must cover at no cost and what you should expect to be offered without asking. The second group requires a conversation, and a decision either way is defensible.
- Ask specifically whether the provider is in network before the appointment. The no-cost-sharing guarantee generally depends on it, and an out-of-network screening can arrive as a full-price bill.
- Expect the follow-up to be billed differently. A screening colonoscopy and a diagnostic one following an abnormal result are not the same billing event, and neither is a biopsy. Ask how a positive result will be coded before you agree to the test, not after.
- Check your list against the current recommendation rather than against what you were told a decade ago. Colorectal moved from 50 to 45. Mammography moved to 40. Lung cancer eligibility widened. Hepatitis C became universal for adults under 80. Each of those changes left a cohort of people who think they are not eligible.
- If the answer for your age and risk is Grade I, understand that means unknown, not safe and not harmful. That is a reasonable basis for either choice, and not a reason to feel you have failed a test.
One coverage note. The no-cost-sharing rule applies to most plans, but the specifics depend on your plan documents, and plan year is when the terms are set. If you are picking coverage, it is worth reading the preventive services language rather than assuming, which fits alongside the mistakes people make during open enrollment.
The limits of a list
Everything above is a population-level recommendation. The Task Force grades a service by its average net benefit across a defined group, which means the grade describes the group and not you. Personal and family history, previous abnormal results and existing conditions all shift the calculation, sometimes substantially, and those shifts are exactly what a clinician is for.
It is also worth being clear about what screening does and does not do. It finds disease earlier in some people, which helps some of them. It also generates false positives, additional procedures, anxiety and overdiagnosis of conditions that would never have caused harm. The Task Force’s grades are an attempt to quantify that trade honestly, and the existence of Grade D and Grade I recommendations is evidence that the exercise is real rather than promotional.
The useful thing this list gives you is not reassurance. It is the ability to walk into an appointment knowing which three or four items apply to you this year, which ones your plan has to cover, and which ones are genuinely a judgment call. That is a smaller claim than most health content makes, and it is the one that holds up.
Where these figures come from
- US Preventive Services Task Force, Grade Definitions
- US Preventive Services Task Force recommendation statements on colorectal cancer screening (2021), breast cancer screening (2024), lung cancer screening (2021), cervical cancer screening (2018), prediabetes and type 2 diabetes screening (2021), hypertension screening (2021), osteoporosis screening (2025), abdominal aortic aneurysm screening (2019), hepatitis C screening (2020), statin use for primary prevention (2022), prostate cancer screening (2018), and depression and suicide risk screening in adults (2023)
- Healthcare.gov, Preventive care benefits for adults
- Supreme Court of the United States, Kennedy v. Braidwood Management, Inc., decided June 27, 2025
General information, current as of October 2026, and not personalised medical advice. Recommendations and coverage rules change; check the primary sources and discuss your own history with a clinician before acting.
