Sexually transmitted infection (STI) screenings & counseling
Medicare Part B (Medical Insurance) covers STI screenings and behavioral counseling sessions if you’re eligible
Description
STI screenings and counseling include confidential medical tests and discussions with a doctor or other health care provider to find, prevent, and treat infections spread through sexual contact.
Coverage details
Part B covers:
- STI screenings for chlamydia, gonorrhea, syphilis, and/or hepatitis B.
- Up to 2 face-to-face, high-intensity behavioral counseling sessions. Each session can be 20-30 minutes long.
Who's eligible
- You can get STI screenings if you’re pregnant or at increased risk for an STI.
- You can get behavioral counseling sessions if you’re a sexually active adult at increased risk for an STI.
Provider requirements
Your health care provider must order the screening or refer you for behavioral counseling.
Costs
You pay nothing if your primary care doctor or provider accepts assignment .
How often
- One STI screening every 12 months, or at certain times during pregnancy.
- Up to 2 behavioral counseling sessions a year.
Facility
Medicare will only cover counseling sessions with a provider in a primary care setting (like a doctor’s office). Medicare won't cover counseling as a preventive service in an inpatient setting (like a skilled nursing facility ).
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service