Medicare covers a wide range of preventive care services, such as wellness checks and screenings for a variety of conditions, including Sexually Transmitted Disease (STD) testing. STDs can be caused by bacteria, viruses, or parasites. An STD is passed from one person to another through the exchange of body fluids during sex acts. STDs are very common. Some people carry an STD but have no symptoms. However, people without symptoms can still pass the STD on others. That’s why it is important to get tested if you think you may have been exposed, even if you don’t have symptoms. While some infections are more easily spread through unprotected vaginal and anal sex, you can contract an STD through oral sex and skin-to-skin contact as well.
Sexually transmitted diseases includes:
- chlamydia
- syphilis
- genital herpes
- human papillomavirus (HPV)
- genital warts
- HSV-2
- gonorrhea
- HIV
- Hepatitis B
MEDICARE COVERAGE FOR STD TESTING
The different parts of Medicare provide coverage in certain situations.
Medicare Part A, which covers inpatient hospital costs, usually does not cover STD testing. But in a case where a person is admitted to hospital as an inpatient and receives the test as part of their whole inpatient care, Part A will cover the costs of testing and screenings.
Medicare Part B generally provides coverage for almost every outpatient service, including STD testing.
Medicare Advantage (Part C) must have at least the same coverage as Original Medicare – Part A and Part B. That means that STD testing must be covered in Part C, like it is described above in Parts A an B.
Medicare Part D do not cover STD testing, but it covers any medically necessary medication that is prescribed to treat diagnosed STD.
Person does not have any costs for STD testing if they are enrolled in Medicare Part B or Medicare Advantage.
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.
ELIGIBILITY FOR STD TESTING
To be eligible for the screening, you must either be:
- Pregnant, or
- Have an increased risk of an STD
High risk for being infected with STD imply:
- having multiple or anonymous sexual partners
- having sex under the influence of drugs or alcohol
- inconsistent use of sexual protection
- IV drug use
- high prevalence of STDs in a community
- have been diagnosed with STD within last year
SPECIFIC TESTS
Medicare covers tests for next STDs once a year as a part of preventive care:
- chlamydia
- gonorrhea
- syphilis
- hepatitis B
Medicare also covers the cost of an HIV test once a year for people aged 15 – 65 years and those outside of this age range who have an increased risk of HIV. Also, during pregnancy, a person may have up to 3 HIV screenings covered by Medicare.
TREATMENT COVERAGE
Usually, people need to wait a few days for STD test results. Medicare then covers treatment following a positive test. The type of treatment necessary may vary depending on the specific condition.
For example, chlamydia, syphilis, and gonorrhea develop due to bacterial infections, which require treatment with antibiotics. When viruses cause STDs, such as herpes, a doctor may prescribe antiviral medications. Medicare covers the cost of both of these types of drugs.
Medicare Part D plans generally cover the medications that doctors use to treat STDs, but some out-of-pocket costs may apply.
If an infection or disease becomes severe enough to require inpatient care, Medicare Part A will cover the eligible costs.