Tuberculosis (TB) is a highly contagious disease caused by bacteria that may infect the lungs, kidneys, spine or brain. Because the disease can be present without any symptoms, a TB test can help confirm whether you’ve contracted TB or not.

Understanding Tuberculosis

Once TB bacteria enters the body, your immune system works to fight against the bacteria as it tries to grow and prevent it from becoming an active disease. While the bacteria will always remain present in the body, a successful immune response relieves you of any symptoms. This TB-related condition is known as a latent TB infection. People with latent TB infection cannot spread the disease to others.

Active TB disease can still occur if your immune system weakens enough to allow the bacteria to grow and spread. Once this happens, you may experience the following symptoms:

  • Persistent cough for 3 weeks or longer
  • Blood or mucus when coughing
  • Chest pain
  • Lack of appetite
  • Weight loss
  • Fever or chills
  • Night sweating

Anyone experiencing an active TB disease can spread it to others by coughing or sneezing near them. TB is considered highly contagious because coming into contact with even a small amount of bacteria can cause an infection.

Risk Factors for Contracting Tuberculosis

Although TB is considered uncommon in the United States, there are circumstances that increase the risk of exposure to the bacteria.

  • Environment. Living in close quarters with other people, such as in a shelter or long-term care facility, raises the chances of contracting this disease if anyone is experiencing an active version of TB.
  • Employment. Health care workers may be exposed to active TB disease while caring for infected patients.
  • Health. Medical conditions that weaken the immune system may mean a person has a higher chance of experiencing active TB disease if they are exposed to the bacteria.
  • Travel. Visiting or temporarily living in countries where TB is more prevalent means you have a greater risk of contracting the disease.

Speak with your physician about your medical history and any lifestyle factors that may expose you to TB. This can help them evaluate the need for a test if there are no symptoms present.

Treatment for Tuberculosis 

Even when TB bacteria is latent, it may be necessary to treat the infected person to prevent the disease from becoming active and infecting others. Medications that are effective against latent or active TB infection may be administered on a weekly or daily basis over the course of several months.

Some strains of TB bacteria are resistant to some medications and may require an intense treatment regimen that can have adverse side effects and may be life-threatening. Active TB is fatal when improperly treated, so patients with a drug-resistant infection may choose to endure the side effects of more potent treatments despite the risks associated with them.

Medicare Coverage for a TB Test

The most common test for TB involves an injection of fluid beneath the skin. This fluid, known as tuberculin, will cause a visible reaction in people who are infected with TB bacteria. It requires two visits to complete: the injection is administered during the first visit and the reaction is examined at the second visit 2-3 days later.

Because people who have previously received a tuberculosis vaccination can have a false-positive reaction to the skin test for TB, a blood test may be ordered instead. Additional testing may be required in either case to determine if the patient has a latent or active version of the disease.

Based on the recommendations of the U.S. Preventive Services Task Force, routine screenings like a TB test should be covered without any cost-sharing obligations. Original Medicare benefits may limit how frequently this test can be administered in a calendar year, however.

If a physician determines high-risk factors are present and more than one test a year is necessary to evaluate a patient for treatment, it’s possible that additional screenings may also be covered under Medicare Part B.

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