Original Medicare (Parts A & B): Sexually Transmitted Infection Screenings and Counseling

Those at increased risk for an STI are those who are sexually active without protection, especially with multiple sexual partners, and those who share needles for injection (whether prescription or illicit substances).  Contrary to popular belief, the older adult population is no exception.

While it might not be the first thing that comes to mind, sexual activity, including with multiple partners, is not uncommon among older adults, especially in community living settings such as retirement neighborhoods, independent living, assisted living, or memory care. Likewise, sharing injection needles, especially among those with diabetes, is common.  And there is illicit intravenous drug use among older adults, as well.  Both behaviors can lead to significant health issues.

These behaviors can result in contracting chlamydia, gonorrhea, syphilis, and Hepatitis B.  An STI screening will check for each of these infections. An STI screening is available every 12 months for those at increased risk for infection when ordered by a primary care provider in a primary care setting.

Also covered are up to 2 face-to-face, high-intensity behavioral counseling sessions per year for sexually active adults at increased risk for STIs. Each session can run for about 20–30 minutes.

Things to know

A primary care provider must order the screening or make a referral for behavioral counseling. Only counseling sessions with a primary care provider in a primary care setting (like a doctor’s office or clinic) are covered. Counseling as a preventive service in an inpatient setting (like a skilled nursing facility) is not covered.