Medicare beneficiaries should understand the STD treatments and Services Medicare covers. This coverage is important because it helps you get fast treatment. Also, having this coverage means your less likely to spread the disease or infection.
Sexually transmitted diseases also known as STDs can affect everyone from the elderly to the youth. STD treatments are for any and everyone that contracts an STD.
A repercussion of irresponsible sex is the chance to contract a sexually transmitted infection (STI). According to the Centers for Disease Control and Prevention (CDC), a sexually active person is at risk for various diseases.
The CDC says people over the age of 50 are commonly receiving an HIV diagnosis, and that number is growing. CDC data from 2014 says 40% of people 55 and older had a late AIDS diagnosis. Due to the delay in treatment, those people have more immune system damage.
Medicare Coverage of STD (SDI) Treatments and Screenings
According to the National Institutes of Health, STD treatments typically include prescription drugs that might be needed like antibiotics. To avoid STD or STI treatments, practice regular prevention tactics and proper screenings.
Not all STD and STIs come with symptoms, many show zero signs, making the spread of disease extremely easy.
Medicare may cover screening for sexually transmitted diseases and sexually transmitted infections, both are medically necessary to screen. These screenings fall under Medicare Part B (medical insurance) as a preventative service.
However, Medicare Part B may not cover STD treatment; although, it may cover screening lab tests for gonorrhea, syphilis, chlamydia and/or hepatitis B.
Coverage is for those who need short counseling sessions on STD/STI prevention. These counseling sessions consist of 2 individual 20-30-minute, face to face sessions at a high-intensity.
The Centers for Disease and Control Prevention (CDC) suggests STD screening for those who:
- Are ages 13-64
- Are sexually active
- Had multiple sex partners
- Got a new sexual partner
- Have a sex partner who is or has been infected with an STD/STI
- A man with a male sexual partner
- Are pregnant
- Use drugs/needles and share them with others
Medically Necessary STD Tests
Your doctor or healthcare provider must order the test or refer you for behavioral counseling for Medicare coverage. With behavior counseling, individuals must receive counseling in a primary care setting; otherwise, Medicare might not cover the cost.
Counseling in an inpatient setting such as a skilled nursing facility, won’t have coverage as a preventative service. The type and how often STD screening is Medicare covers is dependent on the individuals’ circumstance.
Women at high risk might be eligible for Medicare coverage for annual chlamydia and gonorrhea. Both women and men at risk might be eligible for Medicare coverage for annual syphilis lab tests.
HIV screenings have Medicare coverage once every 12 months for any beneficiary who asks; if the beneficiary is pregnant Medicare may pay up to three times during pregnancy.
Talk to your doctor about STD/STI screenings and treatments at your next annual Medicare Wellness visit.
Keep in mind that your doctor may suggest certain services Medicare doesn’t cover. Also, you may be responsible for costs that Medicare doesn’t cover. Ask questions if you’re unsure of services or treatments your plan covers.
STD Treatment and Medicare Prescription Drug Coverage
Stand-alone Part D or a Medicare Advantage Prescription Drug Plan might have coverage for medications to treat STDs or STIs.
Many STD treatments often require prescription medications. Medicare Prescription Drug Plans have a formulary, this is a list of medications the plan covers. However, medications used to treat HIV (human immunodeficiency virus) are in a separate class of drugs; also known as a “protected class”.
Medicare plans offering prescription drug coverage must include “all or substantially all” drugs from this class. However, formularies may change any time; you’ll receive a letter of notification from your plan when necessary.
How Medicare Supplement Covers STD Treatments and Services
With a Medigap policy; when Medicare covers the benefit, the Medigap policy also covers the benefit. This means a beneficiary with Medigap coverage could pay little to nothing for STD treatments and services.
Applying for Medigap coverage is simple, an application can be done over the phone. Just call one of our agents at the phone number above. You can fill out an online rate form to discover the best rates in your area.
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