STI Testing With and Without Insurance

The possibility that you may have a sexually transmitted infection (STI) can be unsettling, but finding affordable STI testing doesn't need to be an additional worry. You may be wondering if insurance covers STI testing and what your options are if you aren't insured.

Learn about insurance coverage for STI testing below.

STI Screening and Diagnostic Testing

Under the requirements of the Affordable Care Act (ACA), most private insurance plans and public health insurance programs like Medicaid must provide coverage for STI screening and counseling with no cost sharing. Note that screening and counseling are different from diagnostic testing.

Screening tests check for disease in people who don't have symptoms but may have risk factors; they're usually recommended on a specific schedule. Screening tests for STIs are covered under the ACA.

Testing someone who has symptoms suggestive of an STI is considered a diagnostic test. A diagnostic test may or may not be covered depending on the specific STI test being done. It may be considered preventive care, which does fall under the purview of the ACA.

If you have health insurance, STI screening is probably free for you or is at a reduced price, but coverage for STI diagnostic testing depends on your insurer and insurance plan. Contact your insurance provider directly for further details on coverage for STI screening and STI diagnostic testing.

STI Screening Coverage Requirements

Although the ACA helps cover preventive STI screening tests for many, coverage does depend on the STI being screened for, in addition to age, sex, and other factors like pregnancy status.

The ACA does require insurance companies to cover HIV screening for those ages 15 to 65. Those who are younger than 15 or older than 65 and who are considered to have an increased risk are covered as well. Individuals may face increased risk if:

• They have condomless sex
• They have multiple or anonymous sexual partners
• They have tested positive for another STI
• They're a man who has sex with men (MSM)

The ACA also requires insurance companies to cover syphilis screening for all adults and for adolescents who are at increased risk.

Screening coverage for other STIs depends on different factors.

For chlamydia and gonorrhea screenings, all sexually active females (including those who are pregnant) who are 24 years and younger or older than 24 and are at increased risk are covered under the ACA. Sexually active boys and those between 11 and 21 years who are at increased risk for infection are also covered.

STI Testing Without Insurance

Without either private or public health insurance, STI screening at a healthcare provider's office or hospital can be pricey.

You may have to pay a healthcare provider's visit fee in addition to paying for the test itself. In total, prices can range anywhere from $25 to over $200.

However, many public health clinics and centers offer low-cost or potentially free STI screening options for those without insurance. These can include:

• Local health department STI clinics
• Planned Parenthood health centers
• LGBTQ+ centers
• Family planning clinics
• College or university student health centers
• Mobile clinics

Be sure to call ahead to ask about testing availability and cost if you're interested in going to any of the clinics or centers listed above. Prices can vary depending on factors such as what tests you need, your household size, and your income level. They will give you details on how they charge for STI screening and if you qualify for a free screening test.

What About Home STI Tests?

Home STI testing is direct-to-consumer testing that can be done in the privacy of your own home. Home STI testing kits are usually bought online through a test supplier's website or over the counter at a pharmacy.

Many STI testing kits allow you to test for one or multiple STIs at a time. The testing kit supplier provides the tools and instructions to take blood, urine, and/or oral swab samples. You then need to send the samples back to a designated lab by mail or take the samples to a lab in your area.

There are also oral HIV tests available that give results at home within minutes.

If you have insurance, know that home STI tests are not specifically covered under the ACA. Coverage varies depending on the insurance provider and the test supplier you choose, making it a good idea to contact your insurer before buying one. Know, however, that most test suppliers do not accept insurance.

Costs for kits can range from $29 to $300 or more, depending on the STIs being tested for.

STI Screening Guidelines

Whether you are concerned about possible recent STI exposure or want to include STI screening as a part of your preventive healthcare routine, knowing when and how frequently to test can benefit your health.

The U.S. Preventive Services Task Force recommends HIV screening at least once for all individuals aged 15 to 65 years. The CDC also recommends that individuals ages 13 to 64 get tested for HIV at least once. Those who face increased risk for HIV should get screened at least once per year.

Women who are sexually active and either under age 25 or 25 and older with risk factors, such as multiple or new sex partners, should be tested for gonorrhea and chlamydia at least once every year.

MSM should be tested for syphilis, chlamydia, and gonorrhea at least once every year but in intervals of three to six months if they have multiple or anonymous partners.

Your healthcare provider will likely give you additional guidance on how often you should get tested. If you are insured, your plan provider can give you the exact details on how often you're covered for all types of STI tests.

A Word From Verywell

It's important to get routinely screened for STIs, especially if you are at an increased risk of acquiring an infection. Coverage for screening and diagnostic testing can vary by disease and testing type, so ultimately your insurer is the best resource for clarification on any questions you may have about coverage or other associated medical costs.