Cervical
Get a Pap smear and HPV test at zero cost
Last reviewed July 1, 2026
Cervical cancer screening — Pap smear, HPV test, or both together (co-testing) — is covered at 100% under the ACA for women 21-65. This is one of the most successful cancer screenings in history: cervical cancer deaths have dropped by more than half since routine Pap testing became standard. And it’s essentially free if you know how to book it.
The steps
Book it as a well-woman visit or preventive care visit, not as a "problem visit." That distinction is what triggers 100% coverage under ACA Section 2713. If you have specific symptoms, mention them, but the visit code should still be preventive first.
Current guidance from ACS: Pap every 3 years for women 21-29. Pap + HPV co-test every 5 years for women 30-65 (or HPV test alone every 5 years). Beyond age 65, screening usually stops if you’ve had consistent normal results. This is different from USPSTF, which recommends Pap every 3 years for 21-29 and Pap or HPV or co-test every 3-5 years for 30-65. Both are within the ACA-covered range.
If you’ve had HPV vaccination (Gardasil), you still need screening. The vaccine covers most but not all cancer-causing HPV strains.
This applies when
- You have ACA-compliant insurance
- You’re 21-65 (some plans cover through 65 or beyond with risk factors)
- You have Medicare (Pap smears covered every 24 months, annually if high-risk)
- You have Medicaid (varies by state, but usually covered)
This doesn't apply when
- You have symptoms (abnormal bleeding, pelvic pain, unusual discharge), that's a diagnostic visit, not preventive
- You're outside the recommended screening age range with no high-risk factors
- You've had a total hysterectomy that included removal of the cervix (Pap testing isn't applicable)
- You had a normal Pap or HPV test within the recommended interval and don't need repeat testing yet
Resources
National Breast and Cervical Cancer Early Detection Program (NBCCEDP): Free or low-cost Pap and HPV testing for women who qualify by income. cdc.gov/cancer/nbccedp.
Planned Parenthood: Sliding-scale Pap smears and HPV tests, often at rates far below other clinics. Call 1-800-230-7526.
Community health centers (HRSA): Sliding-scale rates. findahealthcenter.hrsa.gov.
Local health departments: Often provide free or low-cost screening, especially during Cervical Cancer Awareness Month (January) and Women’s Health Week (May).
If you're denied
If you’re billed for a preventive Pap smear or HPV test, it’s a coding error. Call the insurer, cite ACA preventive coverage, and request reprocessing. The most common error: the visit was coded as "problem-focused" when it should have been "preventive." Ask your provider’s billing office to fix the code and resubmit.
