It’s known that HIV is a severe, sexually transmitted disease (STD). Annually, there are around 40,000 cases of HIV in the US. Moreover, few people know that they have this disease because statistics suggest that of 1.2 million HIV patients in the US, only one out of seven knows that they carry HIV. Medicare Part B covers HIV screening for people aged 15-65, pregnant women, and high-risk individuals.
A lesser-known fact is that HIV can lead to Acquired Immunodeficiency Syndrome (AIDS). AIDS is dangerous and doesn’t have an effective cure. However, there can be a reduction in the spread of HIV by testing and diagnosing it early. Moreover, diagnosing HIV can also reduce care costs and increase patients’ life expectancy. Several effective treatments allow HIV and AIDS patients in the US to live longer. HIV screening or testing is the first step to providing medical care and support for HIV patients to improve their health and adopt a healthy lifestyle.
When it comes to HIV Screening, does Medicare cover it?
If you fulfill the criteria, Medicare Part B will pay for a single annual HIV screening test at 100% of the Medicare-approved amount. Up to three HIV screenings per year during pregnancy are covered at no cost to the patient.
No out-of-pocket costs such as deductibles, copays, or coinsurance apply if you qualify for this screening. If you are eligible for Medicare and receive an HIV test from a provider in your Medicare Advantage plan’s network, your out-of-pocket expenses will be covered in full.
For accurate results, your doctor or other medical professionals must obtain an HIV test that has been cleared for use by the FDA.
Before Medicare pays for an HIV screening, both the healthcare provider conducting the test and the manufacturer of the testing materials must be approved by Medicare providers.
You must meet certain criteria to receive a free HIV test annually through Medicare Part B.
- Age 15-65
- People at high risk who are either younger than 15 or older than 65
- Or, pregnant
Pregnant women are eligible for coverage for up to three HIV screenings during pregnancy.
When you see a physician who accepts Medicare, you won’t have to pay anything for your HIV test if you have Original Medicare. You won’t have to pay anything (no deductible nor coinsurance). As long as you attend an in-network provider and are otherwise eligible for the service, your Medicare Advantage Plan is obligated to cover the cost of your HIV screening without charging you a dime.
Your doctor may find something during your screening that necessitates further testing or treatment. You’re getting this treatment because your doctor thinks it’s necessary based on your symptoms and risk factors. Even when you’re seeing a doctor for preventative care, Medicare may still bill you for any diagnostic tests they run.
All in all, NewMedicare has several resources that can help you reduce the risk of HIV and provide you with medical institutions that engage in HIV screening.