STD Testing: Does Your Insurance Provide Coverage?

Many of us, when choosing an insurance plan, rarely check if sexual health is covered. You’ll be happy to know, however, that most insurance plans include STD testing either at an STD testing clinic or at a doctor’s office. But then, you need to check out the specifics that the coverage provides as different insurance companies have different policies. Usually, asymptomatic STD screening is under the preventive care service. You can always call your insurance provider or check on their website to find out what STD tests are covered and any other preventive care services on the list.

Understanding preventive care

Preventive care is a separate category of services that’s different from diagnosis and treatment, and it’s usually billed separately. If you already exhibit symptoms, your testing is no longer considered as preventive, and this won’t likely be fully covered by your insurance.  

Some types of preventive care are:

• Alcohol misuse screening and counseling
• Blood pressure screening
• Cholesterol screening
• Colorectal cancer screening for adults over 50
• Depression screening
• Diet counseling

The Affordable Care Act (ACA) outlines that gonorrhea preventive screenings and chlamydia testing are free for women under 24 years old, and for women older than this, they are also covered, especially if they are high-risk. HIV and syphilis screenings for sexually active women and men are outlined in the ACA and they may give HIV home test kit too.

Insurance provider coverage

Here’s a brief from the four largest providers in the US and the kind of coverage that applies to sexual health:

• UnitedHealth Group – covers testing for gonorrhea, chlamydia, syphilis, and HIV for women. There’s also counseling provided for women tested for HIV. For men, HIV testing is covered for ages 9 to 26, but no other information for men is provided.
• Anthem – Anthem provides a very accessible platform where you can check what preventive care services are available to you based on gender and age. Generally, there’s at least one sexually transmitted disease screening for sexually active persons, per age group and gender.
• Aetna – provides yearly STD testing coverage for both men and women, although they haven’t specified what STIs are covered.  
• Cigna – Women under 24 years old are provided with chlamydia and gonorrhea screening, and for women above this age group, screening is provided if they are high-risk. No information is provided for men.

Why should your insurance provide coverage for STD testing? 

The better question would be – why shouldn’t they? Insurance plans with STD testing open up the possibility of more people getting tested since it lowers the cost of testing for the recipient. Cost is normally a barrier for people wanting to get tested, so if you haven’t signed up for an insurance plan, look for one that does give adequate coverage on preventive care services. 

Who will be able to see your STD results if you use insurance?

Another common barrier to testing is social stigma. Plenty of people don’t get tested until symptoms start showing, and this is usually at dire stages. When it comes to confidentiality, any tests taken using your insurance plan is part of your medical record and will be used by your insurance provider in the future. The clinic that does the testing reports the results to the insurance company, which then contacts you directly. This means that the results are often accessible by the affiliates of the company.

An Explanation of Benefits (EOB) is usually given by the insurance provider to the primary account holder for billing purposes, and this EOB may include information about the tests taken by other account members. If you’re on a family insurance plan, this information may be sent to the primary account holder or sent to your home. Insurance providers also have online portals that provide individual access to tests taken and their results. 

What’s the cost of an STD test with insurance?

The Affordable Care Act (ACA) has guidelines for different types of STD screening, depending on what you’re screening for. Chlamydia, syphilis, gonorrhea, HIV screening for women, syphilis, and HIV screening for men are FREE. If your tests aren’t included as part of the preventive screening care, or if you have symptoms and have done diagnostic testing, the out-of-pocket costs may differ based on your insurance plan. Some clinics do offer a single free test for qualifying patients, but usually, you need to show proof of income and also have no insurance to be eligible for this.

What’s the difference between preventive screening and diagnostic testing?

Screening involves a basic test administered to patients who don’t show any signs or symptoms of the illness they are testing for. On the other hand, for a person who has displayed symptoms, the circumstances change as the possibility of uncovering something more serious increases. 

This is when a diagnostic test is done, which is usually administered to confirm the condition the person is experiencing once the initial phase of testing has shown the possibility of the illness. Diagnostic tests are much more expensive and usually riskier than the initial tests, but their usefulness outweighs the risks involved. Biopsies and scans are usually the most common types of diagnostic tests available.  

What’s the cost of an STD test without insurance?

Generally, testing for STDs costs anywhere between $60 to $90 depending on the test. Some clinics offer a combination of test kits that allow you to test various sexually transmitted infections, and these test kits are usually more cost-effective than individual test kits. However, keep in mind that test kits are best used for routine asymptomatic testing, and not when you already have a more aggressive form of symptoms.

What to consider for STI testing?

The choice of going to a doctor, visiting a free clinic, or even doing a test with a kit depends on a few factors. These are:

• Do you have a regular doctor or physician you’re comfortable seeing?
• What’s the coverage plan of your insurance for STD testing?
• How comfortable are you talking to a doctor or physician about sex?
• Is your doctor comfortable with dealing with sexual issues?
• What kind of testing options are available to you at the clinic?

What are the pros and cons of seeing a doctor?

Seeing a medical professional or doctor is the most advisable step to any kind of ailment or illness you may have. Texas Telemedicine Rules Curogram is another provider you can talk to also for any advice. While you may dread speaking with your regular doctor about your sexual health, keep in mind that there are many advantages of doing so. These include: 

• It offers more convenience to speak to a doctor who’s familiar with you and your medical history. 
• Less stigma associated with visiting a doctor compared to an STD clinic.
• You have easier access to your medical records.
• You have a better understanding of your overall health
• The doctor has a history of your medication prescription and any potential risks, such as allergies. 
• Depending on your insurance coverage, visiting a doctor for STD testing and treatment can be quite expensive.

In situations when you may not be able to afford to test, it’s advisable to sign up for a testing kit. Not all insurance companies may pay for your preventive care, especially if you don’t show symptoms. Also, your doctor may not have access to do a specific test for STD.  

What are the pros and cons of going to an STD clinic?

The major benefit of going to a free clinic for STD cases is that they will have access to tests and tools to do any kind of STD screening. STD is all that they focus on. Other benefits include:

• It’s more affordable than going to see a doctor.
• You’ll have wider access to STD test options not commonly found in private clinics.
• You’ll have health care professionals who are up to date on current STD treatments.
• There may be a rapid testing option available for you where you can get tested within one single visit.
• You’ll have doctors who specialize in sexual health, which allows you to talk about other issues or concerns you may have.

No doctor should discriminate against you for having an STD, or even coming to a clinic to test for STDs. However, there have been cases of discrimination, and have been known to make it a little difficult for people to receive the right care after getting diagnosed, especially for HIV.

That said, these cases are rare, and by right, illegal, which you can report on. However, this kind of discrimination is less likely to happen in a free clinic for STD screening. Its main job is all about sexual health, anyway.  

The major disadvantage of using free clinics for STD cases is the inconvenience specifically related to their opening hours. These clinics don’t operate at convenient times and usually have very long waits.

Final Thoughts

It’s always a good idea to get insured for your medical future, as this can help you in case of any unforeseen medical issues related to your physical or sexual health. You can also check out the options you have between your doctor, testing kit, or STD clinic before you make a final decision.