Does Medicare provide cover for STD testing? Cost, follow-up, and more - Medical News Today

Does Medicare provide cover for STD testing? Cost, follow-up, and more - Medical News Today


Does Medicare provide cover for STD testing? Cost, follow-up, and more - Medical News Today

Posted: 29 Jan 2021 04:03 AM PST

Medicare provides coverage for various healthcare screenings and tests, including those for sexually transmitted diseases (STDs), also known as sexually transmitted infections (STIs).

People commonly use the terms STD and STI to describe health conditions that transmit between individuals through sexual activity.

As some sexually transmitted health conditions often do not produce any symptoms, STI is becoming the preferred term. However, Medicare does not distinguish between the two terms regarding coverage.

Medicare covers STI screenings that may include:

  • blood tests
  • urine tests
  • genital swabs

The type of test depends on what the healthcare professional is investigating.

Medicare sets guidelines for coverage, and a person may have some additional out-of-pocket expenses.

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
  • Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
  • Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

The different parts of Medicare provide coverage in certain situations.

Medicare Part A

Part A covers inpatient hospital costs. Usually, Part A does not cover STI screening, but if a person is admitted to a hospital and receives the test as part of their inpatient care, Medicare will cover the costs.

Medicare Part B

Part B provides coverage for outpatient services, such as preventive testing and screenings, including STI testing.

Medicare Advantage (Part C)

Part C, also known as Medicare Advantage, is the alternative to original Medicare.

Private insurance companies administer Medicare Advantage plans. While specific coverage may vary among plan providers, Medicare requires that all policies have at least the same coverage as parts A and B.

This requirement means that Medicare Advantage plan benefits include STI testing.

Medicare Part D

Part D prescription drug plans do not cover STI testing, but they usually cover any medically necessary medication that a doctor prescribes to treat an STI.

A person does not pay anything for STI testing if they have either a Part B or Medicare Advantage plan, as long as they meet Medicare's eligibility requirements.

Medicare waives deductibles and copayments for these preventive services.

Medicare covers tests for the following STIs:

  • chlamydia
  • gonorrhea
  • syphilis
  • hepatitis B

Medicare also covers the cost of an HIV test once a year for people aged 15–65 years and those outside of this age range who have an increased risk of HIV.

Also, during pregnancy, a person may have three HIV screenings.

In most cases, Medicare Part B provides yearly coverage for the costs of STI testing when an individual who is pregnant or at high risk of contracting an STI receives a referral from their healthcare provider.

High risk

A person's healthcare provider will help determine whether they are at an increased risk of contracting an STI.

The Preventive Services Task Force note several factors that may increase a person's risk. These include:

  • having multiple or anonymous sexual partners
  • having sex under the influence of drugs or alcohol
  • inconsistent use of barrier protection, such as condoms, during sex
  • IV drug use (for hepatitis B)
  • high prevalence of STIs in a community
  • the person having had an STI within the last year

Pregnancy

Medicare also covers STI testing at certain times during pregnancy.

For Part B to cover the costs, a doctor must provide a referral, and a Medicare-certified healthcare professional must administer the test.

Usually, people need to wait a few days for STI test results. Medicare then covers treatment following a positive test. The type of treatment necessary may vary depending on the specific condition.

For example, chlamydia, syphilis, and gonorrhea develop due to bacterial infections, which require treatment with antibiotics. When viruses cause STIs, such as herpes, a doctor may prescribe antiviral medications. Medicare covers the cost of both of these types of drugs.

Medicare Part D plans generally cover the medications that doctors use to treat STIs, but some out-of-pocket costs may apply.

If an infection or disease becomes severe enough to require inpatient care, Medicare Part A will cover the eligible costs.

An STI may transmit from person to person with the exchange of bodily fluids during sex.

As individual sex practices and risks vary, the recommendations for the frequency of testing also vary. An individual should talk with their doctor to determine how often they should consider testing.

In general, the Centers for Disease Control and Prevention (CDC) recommend STI testing as follows:

  • People aged between 13 and 64 years: Recommendations include testing at least once a year for HIV.
  • Females younger than 25 years who are sexually active: The CDC recommend yearly tests for gonorrhea and chlamydia.
  • Females 25 years and older with risk factors: Recommendations include a test yearly for chlamydia and gonorrhea.
  • During pregnancy: Recommendations include HIV, syphilis, and hepatitis B tests in early pregnancy. The CDC also recommend gonorrhea and chlamydia testing for those at high risk.
  • Sexually active bisexual or gay males: Recommendations include testing once a year for gonorrhea, chlamydia, and syphilis.
  • People who share drug equipment or engage in unprotected sex: The CDC recommend HIV testing yearly.

Primarily, Medicare Part B covers STI testing. Prevention, early diagnosis, and treatment for STIs can help prevent further health complications.

Depending on a person's circumstances, age, and risk factors, their doctor may recommend a specific frequency of STI testing.

Usually, a person pays nothing for an STI test, with Medicare waiving the associated deductibles and copayments.

The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.

Chlamydia often doesn't show symptoms — here are the best ways to tell if you have this serious STI - Insider - INSIDER

Posted: 30 Dec 2020 12:00 AM PST

  • Chlamydia, a sexually transmitted disease, rarely causes symptoms, which means it can go undettected for a long time. 
  • Left untreated, chlamydia can cause long-term complications, including infertility in women. 
  • Getting tested frequently if you're sexually active and practicing safe sex are the best ways to prevent contracting chlamydia. 
  • Visit Insider's Health Reference library for more advice.

Chlamydia is one of the most common sexually transmitted infections. It is caused by the bacteria Chlamydia trachomatis. 

Symptoms of chlamydia can include discharge from the vagina or penis, discomfort while urinating, and pain in the pelvic region. However, less than 30% of people infected with chlamydia show symptoms. It is referred to as a "silent" infection because most people who have it tend to be asymptomatic. 

Chlamydia can be treated with antibiotics. "If left untreated, it can cause serious long-term complications," says Krishna Kakani, MD, who has her own OB/GYN practice in Huntsville, Alabama. So getting tested regularly and seeking treatment if you have chlamydia are super important even if you aren't having symptoms. 

Here's what you need to know about chlamydia and how to treat it. 

How do you know if you have chlamydia? 

According to the Centers for Disease Control and Prevention, you can get chlamydia via unprotected oral, vaginal, or anal sex with someone who has it.

"It's entirely possible to have chlamydia and not know it, because most people are asymptomatic. Even if you do have symptoms, they may not appear until several weeks after your sexual encounter," says Kakani. The symptoms may persist or disappear in a few days, but that may not mean the infection has gone. The infection can still harm you if you are asymptomatic

The symptoms of chlamydia can vary among women and men.

If you have a vagina, you may experience symptoms such as:

  • Vaginal discharge or bleeding in between menstrual periods
  • Pain or a burning sensation while urinating
  • Abdominal pain 
  • Pain during sexual intercourse
  • Increased frequency of urination
  • Rectal discharge or bleeding

If you have a penis, you may experience symptoms such as:

  • Unusual discharge from the penis
  • Pain or a burning sensation while urinating
  • Pain or swelling in the genitals
  • Increased frequency of urination
  • Rectal discharge or bleeding

You can also get chlamydia in the throat, which can give you a sore throat; however, it often doesn't cause any symptoms at all.

While all sexually active people could get chlamydia, it is especially common among women between the ages of 15 and 24, according to the CDC. The CDC recommends that you get tested for chlamydia every year, especially if you are:

  • A woman below the age of 25 who is sexually active.
  • A woman above the age of 25 with multiple sexual partners, or if you or your partner have had an STI before.
  • A man who has male sexual partners.

"Chlamydia tests are typically urine tests that require you to provide a urine sample. Your doctor may also do a swab test, by using a cotton swab to obtain a fluid sample from the infected area," says Kakani.

How do you treat chlamydia?

Chlamydia is easily treatable with antibiotics. Your doctor may prescribe a single dose, or a seven-day course depending on certain factors like your age, which parts of your body are affected, and whether or not you're pregnant. Your symptoms should clear up within a few days; however it is recommended that you complete the course and abstain from sexual activity for a minimum of seven days, to avoid passing the infection on to your partner

If your symptoms don't clear up within a week, you should see your doctor again. You should also get tested again in three months, because reinfection is common when it comes to chlamydia. Reinfection can happen if, for example, you have been tested and treated for chlamydia but your partner hasn't been. Having multiple instances of chlamydia can result in serious long-term complications, for people with vaginas especially.

A chlamydia infection can persist for several months if it's not treated. Failure to treat it in the early stages can raise your risk of long-term complications. 

The only 100% effective way to avoid sexually transmitted infections like chlamydia is to refrain from sexual activity. However, if you are sexually active, you can lower your risk of getting the infection by:

  • Using condoms
  • Limiting your sexual partners
  • Avoiding douching, since it eliminates some of the healthy bacteria in your vagina and can increase your risk of getting infections like chlamydia

What happens if you have chlamydia for too long?

The long-term complications that can result from chlamydia include: 

  • Pelvic inflammatory disease, in people with vaginas: The infection could spread upward through your reproductive system and cause permanent damage to your uterus or fallopian tubes. Apart from being very painful, pelvic inflammatory disease can also make it difficult for you to conceive, or result in pregnancies outside the womb, which can be life-threatening. Chlamydia doesn't usually cause infertility in people with penises. 
  • Pregnancy complications, if you are already pregnant: Chlamydia could cause your baby to arrive early. It could also cause pneumonia and conjunctivitis in your newborn.
  • HIV: Having chlamydia can raise your risk of getting HIV. 
  • Reactive arthritis: The chlamydia infection can trigger an arthritic reaction in your body. 

It's important to note that while antibiotic medication can treat the infection and its symptoms, it cannot undo any of the other damage the infection has caused. 

Insider's takeaway

Chlamydia is a common infection that can be treated easily: however, since it often doesn't show any symptoms, you may not realize you have it. Left untreated, chlamydia can result in serious health problems, including infertility in women. Therefore, if you're sexually active, it's important to get tested for it regularly — once a year, at least — even if you don't have any symptoms

One in five Americans has an STI and nearly HALF of infections are in people under age 24 - Daily Mail

Posted: 26 Jan 2021 01:05 PM PST

An estimated one in five Americans has a sexually transmitted infection (STI), a new report finds.

Data published by the Centers for Disease Control and Prevention (CDC) shows there were nearly 68 million STIs on any given day (prevalent) and 26 million newly acquired (incident) STIs in 2018. 

What's more, almost 50 percent of all incident STIs were diagnosed in those between ages 15 and 24 years old. 

The report also found that STIs acquired that year cost the American healthcare system nearly $16 billion in direct medical costs alone. 

The CDC says its new estimates are critical to 'better understanding the scope of STIs in the U.S.' and that more measures are needed to 

New figures from the CDC estimate that on any given day in the U.S. there were 67.6 million sexually transmitted infections (STIs) in 2018

New figures from the CDC estimate that on any given day in the U.S. there were 67.6 million sexually transmitted infections (STIs) in 2018

Nearly half, 45.4%, of all newly-acquired infections - for a total of 11.9 million - were among people between ages 18 and 24 (above)

Nearly half, 45.4%, of all newly-acquired infections - for a total of 11.9 million - were among people between ages 18 and 24 (above)

An STI, sometimes called a sexually transmitted disease (STD), is an infection that is passed from one person to another through sexual contact either vaginally, orally or anally.

Some are bacterial infections that are curable with a single-dose regimen of antibiotics while others are viral infections that cannot be cured but can be modulated with antivirals. 

STIs do not always have symptoms and, if left diagnosed and untreated, can have serious health consequences. 

Some infections can increase the risk of HIV or cause chronic pelvic pain, pelvic inflammatory disease and even infertility.

Currently, STIs cause about 2.7 deaths per 100,000 people, primarily due to HIV and HPV (human papillomavirus) infections.

For the report, published in the journal Sexually Transmitted Diseases, the CDC focused on eight STIs: chlamydia, gonorrhea, trichomoniasis, syphilis, genital herpes, HPV, sexually transmitted hepatitis B, and sexually transmitted HIV.  

The number of prevalent and incident infections was calculated by multiplying each STI's per capita estimate by the full resident population estimate. 

Results revealed an estimated 67.6 million STIs on any given day.

With a population of approximately 320 million people, the authors say this suggests about 20 percent of Americans had an STI at a given point in 2018.

Researchers also found there were about 26.2 million incident STIs in the U.S. in 2018 

The four most common infections were chlamydia, trichomoniasis, genital herpes, and HPV, making up 97.6 percent of all STIs on any given day and 93.1 percent of all newly-acquired STIs. 

Of those new infections in 2018, about half, or 45.4 percent, were contracted by Americans between the ages of 15 and 24. 

'The burden of STIs is staggering,' said Dr Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, in a statement.

'At a time when STIs are at an all-time high, they have fallen out of the national conversation. Yet, STIs are a preventable and treatable national health threat with substantial personal and economic impact.

The new infections will likely cost the U.S. healthcare system an estimated $16 billion in lifetime medical costs, with the most related to HIV treatment (above)

The new infections will likely cost the U.S. healthcare system an estimated $16 billion in lifetime medical costs, with the most related to HIV treatment (above)

What's more, those new infections will likely cost the U.S. healthcare system an estimated $16 billion in lifetime medical costs. 

Most of the cost, $13.7 billion, is attributed to sexually acquired HIV infections due to the lifetime of antiviral treatment.

The second costliest STI was HPV with about $755 million in treatment for not just the infection but also HPV-related cancers.  

Young people ages 15 to 24 account for about 60% of the combined healthcare costs for chlamydia, gonorrhea and syphilis, according to the CDC.

Women make up nearly 75% of the $2.2 billion in non-HIV-related STI medical costs, the agency said.     

'There are significant human and financial costs associated with these infections, and we know from other studies that cuts in STI prevention efforts result in higher costs down the road,' said Raul Romaguera, acting director for CDC's Division of STD Prevention., in a statement.

'Preventing STIs could save billions in medical costs, but more importantly, prevention would improve the health and lives of millions of people.' 

EXPLAINED: CHLAMYDIA, GONORRHEA AND SYPHILIS 

Chlamydia

What is it?

Chlamydia is a sexually-transmitted disease that can infect males and females.

It stems from bacteria called chlamydia trachomatis. It is passed through contact, via vaginal, anal or oral sex.

If left untreated it can damage a woman's fallopian tubes and cause infertility. In very rare cases it can cause infertility in men too.

What are the symptoms?

The majority of people do not feel symptoms of chlamydia. Doctors recommend getting regular STD tests (urine test or swab) to detect it.

However, some do experience some side effects.

Symptoms in women: 

  • Abnormal vaginal discharge
  • Burning feeling when you urinate
  • Pain in the eyes
  • Pain in the abdomen
  • Pain in the pelvis
  • Pain during sex
  • Vaginal bleeding 

Symptoms in men:

  • Discharge from the penis
  • Burning feeling when you urinate
  • Pain and swelling in one or both testicles (rarely)


Symptoms of chlamydia after anal sex:

  • Pain 
  • Discharge
  • Bleeding 

How is it treated?

The infection is easily treated with antibiotics.

Doctors typically prescribe oral antibiotics, usually azithromycin (Zithromax) or doxycycline.

Gonorrhea

What is it?

A very similar STD to chlamydia, gonorrhea is also bacterial, spread through contact.

It stems from bacteria called Neisseria gonorrhoeae.

What are the symptoms?

Women typically do not see symptoms, but men do.

When a woman does experience symptoms, they are very mild and easily mistaken for a bladder infection.

Doctors recommend getting regular STD tests (urine test or swab) to detect it.

Symptoms in men:

  • Burning feeling when you urinate
  • A white, yellow or green discharge from the penis
  • Painful or swollen testicles 

Symptoms in women: 

  • Burning feeling when you urinate
  • Increased vaginal discharge
  • Vaginal bleeding between periods 

How is it treated?

Gonorrhea is curable with antibiotics, although health officials fear this may be the first 'untreatable' STD as the bacteria builds up resistance to our standard methods of treatment.

The CDC recommends treating the infection with a combination of two antibiotics: azithromycin and ceftriaxone.

The infection has already become immune to penicillin, tetracycline and fluoroquinolones.

Increasingly, gonorrhea is building up a resistance to the individual drugs.

Syphilis

What is it?

A chronic bacterial disease, syphilis can be contracted by other means but is typically a sexually-transmitted disease.

In very rare cases, it can be spread through prolonged kissing, as well as the more common routes of transmission: vaginal, anal and oral sex.

It comes from the bacteria Treponema pallidum.

What are the symptoms?

Sufferers develop sores, though these can often go ignored.

The infection develops in stages.

Stage one:

  • Small, painless sores (like ulcers) on genitals or in the mouth
  • Appear within 10-90 days after exposure
  • They disappear within six weeks, and do not leave a scar, before developing to stage two

Stage two: 

  • Rosy rash on the palms of the hand and soles of the feet
  • Moist warts in the groin
  • White patches inside the mouth
  • Swollen glands
  • Fever
  • Weight loss
  • This all fades away without treatment before developing into stage three

Latent syphilis:

  •  Dormant, no symptoms

Stage three:

  • Without treatment it can progress to more severe issues with the heart, brain and nerves
  • Paralysis
  • Blindness
  • Dementia
  • Deafness 
  • Impotence
  • Death 

How is it treated?

In the early stages, patients can receive an injection of Benzathine penicillin G. This will not undo the internal damage but will eliminate the infection.

For those with latent syphilis - and are unsure how long they had it - doctors recommend having three doses of the penicillin injection, seven days apart from each other. 

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