- You can use Medicare to get tested for STDs once per year.
- You can get tested more often if you’re pregnant.
- Medicare covers testing without copayments if you meet the criteria.
- These tests through Medicare are completely confidential.
Medicare covers a range of preventive care services through Part B, such as wellness checks and screenings for a variety of conditions. This includes STD testing. STDs are also known as sexually transmitted infections (STIs).
You can get tested once per year if you’re at an increased risk for an STI. Medicare will cover the cost of testing completely as long as you meet the requirements.
Your coverage will be through Part B if you have original Medicare, or through your Medicare Advantage plan if you have one.
You can get coverage for STI testing through Medicare, but you’ll need to meet Medicare’s requirements. Medicare has slightly different rules depending on the type of test you need.
If you need an HIV test, Medicare will cover it if:
- You’re between ages 15 and 65.
- You’re under age 15 but at an increased risk.
- You’re over age 65 but at an increased risk.
- You’re pregnant.
Medicare will cover testing up to three times while you’re pregnant. In all other cases, it’ll cover HIV testing once per year.
For other STIs, Medicare will cover testing once per year if you’re at increased risk or throughout your pregnancy.
Other STI tests Medicare covers include screenings for:
Medicare might consider you at an increased risk for an STI for multiple reasons. You can get screening if you’ve engaged in any of what Medicare considers “high-risk” sexual practices.
This includes if:
- You’ve had multiple sex partners.
- You’ve had sex without a condom or other barrier method.
- You’ve had sex under the influence of drugs or alcohol.
- You’ve had sex in exchange for money or drugs.
Medicare will also consider you at increased risk if:
- You had an STI in the past year.
- You live in a community that has a high prevalence of any STI.
- You’re a male who has had sex with another male and engaged in one of the practices above.
Additionally, Medicare considers you to be at high risk for chlamydia and gonorrhea if you’re a sexually active woman under age 24.
Finally, Medicare considers you at high risk for hepatitis B if you use any intravenous drugs.
If any of these qualifications apply to you, or if you have any other reason to think you might have been exposed to an STI, talk with your doctor. Your doctor can write you an order for an STI test.
Medicare will cover your test as long as your doctor orders it and you’re at an increased risk.
Medicare covers STI tests for the LGBTQIA community.
As mentioned, Medicare will cover STI testing for a male who has had sex with another male, regardless of how they identify.
Coverage and protections have also been expanded under the Affordable Care Act (ACA). Some new protections than can help with STI testing include:
- The gender listed on your Medicare card doesn’t determine the services you can have covered. This helps transgender people who have not legally changed their gender access appropriate care for them, including STI testing.
- You can get coverage for same gender spouses through Medicare. You can now qualify for Medicare through your spouse’s work credits regardless of the gender of your spouse or your own gender.
- You have the right to protection from discrimination while receiving care. Medicare providers are required to provide the same quality of service to all patients. You can file a complaint with Medicare if your provider doesn’t do so.
STI testing is always confidential.
The Health Insurance Portability and Accountability Act (HIPAA) ensures your privacy when you receive any healthcare, including STI testing.
Plus, the ACA strengthened HIPPA’s privacy laws. This means your results will be confidential and not discussed with anyone without your permission.
You can get an STI test at a variety of other locations if you don’t want to use Medicare. Many of these options are low-cost or free even without Medicare or other insurance. Low-cost options include:
- public health centers
- Planned Parenthood
- nonprofit sexual health centers
- college or university campus health centers
- LGBTQIA centers
- mobile health clinics
You might not have all these options in your community, but you likely have at least one or two of them. You can use Google to search for STI testing near you.
Keep in mind that some of these centers only serve certain populations.
For example, a college health center will likely only do STI tests for students. It’s also a good idea to check online or call before you make an appointment to make sure the specific test you’re looking for is offered.
In addition to these low-cost options, you have a couple of other choices if you don’t mind paying a little more. Options include:
- urgent care centers
- home test kits
You’ll have to pay to use either of these options. However, they might be more convenient. Ultimately, you can choose any provider of STI tests that you’re comfortable with and that fits into your budget.
STI testing can cost anywhere from $0 to $300. Your costs for an STI test will depend on several factors, including the test itself and where you go for testing. Your income can also be a factor since many providers offer sliding-scale costs for STI tests.
You won’t pay anything for resting when you’re using Medicare.
Medicare covers testing with no copayment or coinsurance. As long as your test is ordered by a doctor and you’re eligible, Medicare will pay the entire cost.
Not all parts of Medicare cover STI testing. You’ll need to make sure you have a Medicare plan that covers what you need before you get tested to avoid surprise costs.
Medicare Part A
Part A is hospital insurance. It covers inpatient care you receive at facilities like hospitals and skilled nursing facilities.
It’s not used for things like STI tests. The only exception would be if you received an STI test while you were a patient at a hospital or facility.
Medicare Part B
Part B is medical insurance. Together with Part A, it makes up what’s called original Medicare.
Part B coverage includes STI testing. Any test your doctor orders will be covered through Part B.
You can also use Part B services to get free, confidential information and counseling to help you have safer sex and reduce your STI risk.
Medicare Part C
Part C plans are also known as Medicare Advantage plans. Advantage plans take the place of original Medicare and are required to cover everything that original Medicare does.
So, since Medicare Part B covers STI testing at no cost, all Advantage plans are also required to cover it.
Medicare Part D
Part D is prescription drug coverage. It doesn’t cover things like STI testing. However, it may cover any prescriptions you need for treatment if your test comes back positive.
Medigap plans pay the out-of-pocket costs of using Medicare, like copayments and coinsurance amounts.
Since there’s no copayment for STI tests a Medigap plan wouldn’t affect your costs. If you need treatments, however, a Medigap plan could help lower those costs.
STIs can be caused by bacteria, viruses, or parasites. An STI is passed from one person to another through the exchange of body fluids during sex acts.
You might also see STIs referred to as sexually transmitted diseases (STIs). The two terms refer to the same group of infections, which includes:
- genital herpes
- genital warts
- hepatitis B
- human papillomavirus (HPV)
STIs are very common. Some people carry an STI but have no symptoms. People without symptoms can still pass the STI on others, however. That’s why it’s important to get tested if you think you may have been exposed, even if you don’t have symptoms.
It’s a common myth that you can only contract an STI from a certain type of sex or sex acts — but that’s not the case. While some infections are more easily spread through unprotected vaginal and anal sex, you can contract an STI through oral sex and skin-to-skin contact as well.
Treatment for STIs depends on the specific STI you have. For example, many STIs caused by bacteria can be treated with antibiotics, while STIs caused by viruses require more complex treatment.
Getting treatment as soon as you know you have an STI is important. Early treatment can help you avoid complications from the STI and keep your future sexual partners safe
While all sex carries some risk of transmission, you can take many precautions to keep yourself safe:
- Correct condom use. It’s important to make sure you’re using condoms that aren’t expired, defective, or reused. Make sure you put condoms on securely and that you’re using the right type and size of condoms.
- Communication with your sexual partner. One of the best things you can do to reduce your risk of STIs is to have honest communication with anyone you have sex with. You can make sure you and your partner are on the same page about safe sex by asking them if they’ve recently been tested for STIs and whether they’ve used condoms with all past and current sex partners.
- Good hygiene. Steps like showering before and after sex, not sharing underwear, and making sure you clean off any sex toys can help reduce your chances of passing on or contracting an STI.
- Protection beyond condoms. Since STIs can be transmitted by all types of sex, it’s important to stay safe during all sex acts. You can use dental dams or oral condoms during oral sex and gloves during manual penetration.
- Regular testing. If you’re sexually active, getting testing for STIs often is important. Make sure any new partners are tested as well.
- Sober sexual encounters. Being under the influence of drugs or alcohol can increase your risk of unsafe sex and STIs.
- Vaccinations. You can get vaccinated against both hepatitis B and HPV.
Medicare will pay for STI/STD testing once per year if you meet the criteria. Anyone who’s at an increased risk can get tested without a copayment. During pregnancy, you can get tested more often.
Medicare Part B or your Medicare Advantage plan will pay for testing. Your test will be completely confidential.
Talk with your doctor if you think you might have been exposed to an STI/STD, even if you don’t have any symptoms.
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