Does Medicare Cover STD testing? 

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According to statistics collected by the CDC last year, there were approximately 2.4 million reported cases of the three most common sexually transmitted diseases (STDs) in the United States: chlamydia, gonorrhea, and syphilis.  

It’s important to note the difference between a sexually transmitted infection (STI) and an STD. STIs occur when a person becomes infected with bacteria, parasites, or viruses. If the infections aren’t treated, they can progress to STDs. When STIs or STDs aren’t treated, they can cause serious health issues. Fortunately, STDs and STIs can be successfully treated when testing and diagnosis take place early. 

Testing for gonorrhea, syphilis, chlamydia, and HIV is typically done through urine or blood samples, but some doctors use swabs from the vagina, cervix, anus, or urethra to check for STIs. 
If your health care provider suspects you have an STI or STD, or you have a higher risk of infection, she may prescribe screenings that might be covered by your Medicare insurance. 

Does Medicare cover testing for STDs? 

Original Medicare Part B (medical insurance)covers sexually transmitted infection screenings for chlamydia, gonorrhea, syphilis, and hepatitis B in the following instances:

  • Up to three times a year if you’re pregnant (during your pregnancy)
  • Once every 12 months if you’re at a high risk of infection 

Medicare Part B will also cover one or two in-person behavioral counseling sessions, per year, for beneficiaries who are sexually active and at high risk for STIs. 

Original Medicare Part B pays for 100 percent of STI screenings and related counseling services if the health care provider who orders this care accepts Medicare assignment. The counseling sessions must also be provided by a primary care provider who accepts Medicare assignment, and they must take place in a medical facility like a physician’s office. 

Additionally, Medicare covers HIV screening once a year if you meet the following requirements: 

  • You’re 15 to 65 years old
  • You’re under 15 with an increased risk
  • You’re over 65 with an increased risk
  • You’re pregnant (testing is covered up to three times per year during your pregnancy)

Medicare considers someone to be at an increased risk for STIs if the following apply:

  • Having multiple sex partners
  • Having unprotected sex
  • Having sex while under the influence of alcohol or drugs
  • Having sex for money or drugs
  • Having had an STI within the past 12 months
  • Residing in an area that has a high prevalence of STIs
  • Being a male who’s had sex with another male while engaging in any of the above-listed practices
  • Being a sexually active woman under the age of 24
  • Using intravenous drugs

Medicare Advantage (Part C)plans must cover all benefits included in Original Medicare Parts A and B, at minimum. However, depending on the type of Medicare Advantage plan you have, your provider may cover additional services regarding STI and STD screenings, counseling, and treatment services. 

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