Does Medicare Cover STD Testing?

Medicare Part B is designed to provide preventive care options and wellness checks for patients covered by this federal insurance plan. If you are worried that you may have been exposed to a sexually transmitted disease, also called an STD, you may be wondering if Medicare will cover testing for this issue. In many cases, the answer to this question is yes.

Does Medicare Cover STD Testing?

Medicare will cover at least one STD test each year. If you meet certain criteria, the testing will be provided free of charge to you:

• STD testing will be provided once each year for individuals between the ages of 15 and 65.
• People under the age of 15 or over the age of 65 who are at higher risk of STDs can also be tested once annually.
• Pregnant women can be tested more frequently for STDs under Medicare guidelines.

These services will be covered through Medicare Part B or through your Medicare Advantage plan. The testing process and the results are absolutely confidential.

What Constitutes Increased Risk of STDs?

Under Medicare guidelines, you may be at higher risk of STDs if any of the following criteria apply to you:

• You have had multiple sexual partners.
• An STD is prevalent in your community.
• You have had sex without using a condom, under the influence of drugs or alcohol or in exchange for drugs or for money.
• You have contracted an STD in the past year.
• You are a man who has had sex with another man without a condom or under the influence of drugs or alcohol.
• You are a woman who is sexually active and under the age of 24.
• You are an intravenous (IV) drug user.

If any of these apply to you, you may be eligible for more frequent testing for STDs through the Medicare program.

What Is an STD?

STDs are caused by viruses, bacteria or parasites. Some of the most common STDs include:

• HIV infections can develop into a disease called AIDS, which can have significant and life-threatening effects. The HIV infection can be spread through sexual contact, blood transfusions and breast milk.
• Syphilis is a sexually transmitted bacterial infection. If left untreated, syphilis can cause blindness, mental illness and death. It is treatable and curable with antibiotics.
• Gonorrhea is also a bacterial infection that is transmitted sexually. Its side effects and complications are not as serious as those of syphilis, and gonorrhea is also treated with antibiotics.
• Hepatitis B is a viral infection of the liver that can be acute or chronic. It is highly contagious and can be transmitted through blood or other bodily fluids. IV drug use and sexual contact are two primary ways in which this virus is spread.
• Chlamydia is a sexually transmitted infection that produces no noticeable symptoms in about 70% of men and 90% of women with this condition.

Medicare will generally pay for testing on a once-yearly basis for these sexually transmitted diseases.

Preventing STDs

Some of the best ways to prevent STDs include:

• Using condoms and other protection
• Practicing good hygiene
• Communicating clearly with your sexual partners
• Getting vaccinated against certain STDs
• Being tested regularly if you are sexually active
• Staying sober during sex and avoiding the use of illegal and IV drugs

Medicare has made it easy to obtain the STD testing services you need in an affordable, confidential way. By testing regularly, you can enjoy the best health now and in the future.

Does Medicare Cover STD Testing for People in the LBGTQIA Community?

Medicare covers STD testing for people within the LGBTQIA community on the same basis as all other Medicare recipients. Additionally, under the Affordable Care Act that was enacted in 2010, LGBTQIA individuals and couples were afforded some important new protections:

• Same-gender spouses can receive coverage through Medicare on their partner's work credits.
• Discrimination in the providing of Medicare services is prohibited. All patients are entitled to the same high quality of care.
• Birth gender does not determine whether Medicare will cover services. Transgender persons who have not yet changed their legal gender can access the medical services they need through Medicare regardless of that legal gender.

What If I Don't Want to Use Medicare for STD Testing?

A number of other free or low-cost options are available for STD testing. Planned Parenthood, not-for-profit sexual health facilities, mobile health clinics and public health centers are all good places to start when looking for an affordable solution for STD testing outside of the Medicare system. LGBTQIA organizations may also offer free or lower-cost STD testing for the populations they support. College and university health centers are low-cost STD testing options for students in attendance at these institutions. In general, you should call ahead to make an appointment for these non-Medicare health care options.

If money is not an issue, you can also get tested in an urgent care facility in your area. You may also be able to test for some STDs by using a home testing kit, which will generally be more expensive than most public health testing services.

How Much Will My STD Testing Appointment Cost?

The cost of STD testing will vary depending on where you choose to go, your income level, what kind of testing you require and your insurance coverage. Tests can cost as much as $300 from a private provider. You will pay nothing, however, if you choose to use Medicare to cover these treatments when they are ordered by your physician.

What Medicare Plans Cover STD Testing?

Original Medicare consists of Medicare Part A and Part B. Medicare Part A is generally used to cover the costs of treatment in a hospital or a skilled nursing facility. Medicare Part B is most commonly used to cover STD testing and all other types of tests. If you do not have Original Medicare, Medicare Part C plans are also required to cover the same types of testing as Original Medicare. Also known as Medicare Advantage, these plans will cover STD testing at no cost for you. Medigap coverage is intended to provide assistance in paying copayments or deductibles for Medicare beneficiaries. Because STD testing is available at no cost through these plans, Medigap coverage is not applicable to these services.

In short, Medicare Part A, Medicare Part D and Medigap do not cover STD testing. Medicare Part A and Medicare Advantage plans, however, cover these services at 100% of your costs.