Your Medicare Coverage
Is my test, item, or service covered?
Sexually transmitted infections (STI) screening & counseling
How often is it covered?
Medicare Part B (Medical Insurance) covers sexually transmitted infection (STI) screenings for chlamydia, gonorrhea, syphilis and/or Hepatitis B once every 12 months or at certain times during pregnancy.
Medicare also covers up to 2 individual 20 to 30 minute, face-to-face, high-intensity behavioral counseling sessions each year. These are covered for sexually active adolescents and adults at increased risk for STIs, if referred by a primary care physician or practitioner.
- People with Part B who are pregnant.
- Certain people who are at increased risk for an STI when the tests are ordered by a primary care doctor or other primary care practitioner.
Sexually active adults who are at an increased risk for STIs are also eligible for behavioral counseling sessions.
Your costs in Original Medicare
You pay nothing for STI screenings or counseling if the primary care doctor or primary care practitioner accepts assignment. Medicare will only cover behavioral counseling sessions if they’re provided by a primary care practitioner and take place in a primary care doctor's office or primary care clinic. Behavioral counseling sessions conducted in an inpatient setting, like a skilled nursing facility, won't be covered as a preventive service.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.