Close close icon

Medicare Coverage for Sexually Transmitted Infection Screenings


Medicare covers an annual screening for STIs, including HIV. Also, Medicare will cover sexually transmitted infection screenings and counseling. Medicare will cover screenings for gonorrhea, syphilis, chlamydia, and hepatitis B. These screenings fall under Part B as a preventive service. 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.

Does Medicare Cover Sexually Transmitted Infection Testing?

Medicare’s preventive care benefits include a yearly screening for gonorrhea, chlamydia, syphilis, and HIV. Part B covers the full cost of preventive care, as long as your doctor accepts Medicare assignment.

To be eligible for the screening, you must either be:

  • Pregnant, or
  • Have an increased risk of an STI

Many things can lead to an increased risk, including having more than one sexual partner and not using adequate protection.

Medicare pays for up to two 20 to 30-minute STD counseling sessions with a doctor each year. If you’re concerned about a sexually transmitted disease, talk to your doctor about getting screened.

Does Medicare Cover STD Testing?

Many people use the term STD, or sexually transmitted disease, to mean the same thing as STI. Technically, there’s a difference between the two.

An STI is a viral or bacterial infection. An STD is a more serious condition that can result from that infection. For example, HIV is a viral STI. If left untreated, it can lead to AIDS, which is an STD.

If your doctor suspects you have an STD, the doctor may order tests to confirm the diagnosis. Doctor visits and diagnostic testing are covered by Part B.

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

Does Medicare Cover HIV Testing?

Medicare covers an annual HIV screening test for everyone aged 15-65 who’s on Medicare. It also pays for a yearly screening for younger or older people at risk of contracting the virus. If you’re pregnant, you can have up to thee screenings during your pregnancy.

HIV testing is preventative service. You won’t pay anything for the test as long as your provider accepts Medicare assignment.

Does Medicare Cover Chlamydia Testing?

Medicare covers testing for both chlamydia and gonorrhea in women. Because mothers can pass either infection to an unborn child, Medicare pays for screenings for pregnant women under age 24 or at risk for STIs. Medicare will also pay for repeat screening for pregnant women.

Women of any age with an increased risk of STIs can get an annual screening.

Does Part D Cover STD and STI Medications?

Chlamydia, gonorrhea, and syphilis are bacterial infections that can be cured with antibiotics. Herpes is a viral infection that cannot be cured but can be managed with antiviral drugs.

Part D plans will usually cover both antibiotics and antivirals. These drugs are often available in lower-cost generic forms. Depending on your plan, you may have to pay a copay for your prescriptions.

HIV is an incurable virus that must be managed to prevent it from progressing to AIDS. Doctors prescribe antiretroviral therapy, or ART, to treat HIV. Antiretroviral medications are one of six classes of drugs protected under Medicare.

Part D plans must cover all drugs in protected classes. This ensures that HIV patients will always have access to lifesaving treatments.

Medicare Advantage and Sexually Transmitted Diseases or Infections

If you’re in a Medicare Advantage plan, you can still get an annual STI screening at no cost. Medicare Advantage plans must offer the same benefits like Medicare, but they can require you to use a healthcare provider in the plan’s network.

Prescription coverage is a feature of many Medicare Advantage plans. As with a standalone Part D prescription plan, you can expect your plan to cover many antibiotics and antivirals. Your prescription plan must cover antiretrovirals because they’re in a protected class.

FAQ’s

Does Medicare Cover STD or STI Treatments?
Medicare covers medically necessary healthcare, including doctor visits, tests, and other treatments for STIs and STDs. You can Part B costs. Medigap will cover Part B costs. Further, Medicare doesn’t cover prescriptions, but if you have Part D, it should include medications to cure or manage your condition.
Does Medicare cover online STD testing?
Several companies offer STD testing kits that you can buy online. You obtain the sample needed for testing and then send it back to the company for evaluation.

Medicare probably won’t cover these types of tests. For Medicare to pay for an STD test, a doctor must order it, and the test must be done at a facility enrolled in Medicare.

How much does it cost to get an STD test?
Annual STI screening tests are free for people that are pregnant or at risk for STIs. If you don’t qualify for testing, a test can cost as much as $300.

Community health clinics may offer low-cost STD testing. Some online tests cost between $50 and $100.

How often will Medicare cover STD testing?
Medicare covers STD testing as a preventive service once a year for most people. But, if you are pregnant, you can get a test for chlamydia and gonorrhea after learning you are pregnant, and a repeat test later in your pregnancy. Pregnant people can also get up to three HIV tests during a pregnancy.

Get Medigap to Cover STD Testing and Treatments

Our highly trained agents know Medigap inside and out. We research plans and find the best options for you.

We’ll answer your questions and guide you through the enrollment process. Give us a call at the number above to find your policy match.

Or, fill out our online form to see your rates now!

Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

Comment

Your email address will not be published. Required fields are marked *