Prevention and early detection of sexually transmitted diseases and infections (known as STDs or STIs) is extremely important. Regular testing is essential for every sexually active individual’s health and wellness. Medicare benefits may provide coverage for at-risk recipients under certain guidelines.
Importance of Testing for STDs
Many sexually active adults seek out STD tests after they begin an intimate relationship with a partner, but testing yourself beforehand can help identify any diseases or infections that may be present but asymptomatic. Early detection and treatment of STDs may prevent symptoms from worsening or secondary issues and illnesses from developing.
Although it can be a sensitive subject, asking a partner to get tested for STDs and sharing results with one another is an important step in preventing the spread of disease. Any intimate act can increase the risk of contracting or spreading certain STDs. While abstinence is the only fully successful method of protection against STDs, condoms and vaccinations may help reduce the chances of infection when properly used and administered.
In order to help you determine your risk of exposure to STDs, you should speak openly and honestly with your physician. They can help you evaluate your circumstances and decide which tests you may need and any other preventive or protective measures you should take to maintain your sexual health.
Common Types of STD Tests
A doctor may order several types of tests depending on the circumstances. If symptoms of one STD are present, your physician may suggest performing several tests in case you have been exposed to multiple STDs or to confirm the results of a single test.
- Physical examination. Some STDs, such as genital warts (HPV) or herpes (HSV), can be identified through a simple visual examination of the infected area.
- Tissue swab. A swab of the infected tissue or of the cheek can be used to identify many STDs, such as chlamydia, gonorrhea, herpes, HIV, trichomoniasis or syphilis.
- Urine sample. Chlamydia or gonorrhea can be detected through a urine sample.
- Blood analysis. This type of test may be used if infection is suspected but no symptoms are present. Syphilis, HIV, or herpes can be identified through a blood test.
- Pap test. Women who may have been exposed to genital warts or herpes may be given a Pap test to check cervical cells for infection or for cancer if they are at risk of developing it after an HPV infection.
Medicare Coverage for STD Testing
Different factors dictate what type of testing or intervention is available through Medicare benefits. Age and lifestyle factors play a major role in determining whether a recipient is considered to have an increased risk for contracting STDs.
Medicare recipients who are pregnant qualify for tests that screen for chlamydia, gonorrhea, syphilis or Hepatitis B at certain times throughout their pregnancy. Recipients can also receive up to three tests for HIV during their pregnancy.
Medicare recipients between the ages of 15-65 who are eligible for Medicare coverage due to certain disabilities are covered for one HIV screening per year without the need to qualify for that coverage through other lifestyle factors.
Medicare beneficiaries over the age of 65 or whose lifestyle choices fall under the U.S. Preventive Services Task Force’s definition of high-risk behaviors may have certain STD tests and high intensity behavioral counseling (HIBC) covered under Medicare Part B. Your primary care doctor can help you decide if your sexual history fits the USPSTF’s definition of high risk. A physician’s referral for these tests and services is required and they must be administered by a Medicare-certified health professional.
If a Medicare recipient receives STD tests or counseling during an inpatient stay at a skilled nursing facility, Medicare coverage does not apply.
Dual-eligibles who receive both Medicare and Medicaid benefits may have expanded options for STD testing and counseling if their state provides coverage for it. Medicare Advantage plans are also able to expand coverage beyond Part A and Part B benefits, but coverage will be determined by each private insurer. MA plans may include STD tests and counseling not provided by Medicare Part B. Check with your specific plan for details.