Georgia Medicare STI Screening 2026: What's Covered

In 2026, Medicare in Georgia covers STI screening for chlamydia, gonorrhea, syphilis, and hepatitis B at no cost to you, for adults at increased risk at any age. Being 65 or older does not take you out of that group. Medicare Part B pays the full cost of these screening tests when your primary care provider orders them and accepts assignment, and it adds up to two counseling sessions a year to help you lower your risk. This is one of the most under-used preventive benefits in Medicare, largely because the system too often assumes older adults are not sexually active or not at risk. If you are, this coverage was built for you.1

Does Georgia Medicare Cover STI Screening?

Yes. Medicare Part B covers STI screening for four infections, chlamydia, gonorrhea, syphilis, and hepatitis B, once every 12 months for beneficiaries who are at increased risk, and more often during pregnancy. Your primary care provider orders the test, which is usually a urine sample, a swab, or a blood draw, and Medicare pays the full amount when the provider accepts assignment. The coverage comes from a national Medicare rule, National Coverage Determination 210.10, effective November 8, 2011, added under the additional-preventive-services authority in Section 1861(ddd) of the Social Security Act. It is the same in all fifty states, so a Georgia beneficiary has exactly the same STI screening benefit as one anywhere else.1

What Georgia Medicare STI Screening Costs You

For the screening itself, you pay $0. Medicare Part B waives both the annual deductible (which is $283 in 2026) and the standard 20% coinsurance for STI screening when your provider accepts assignment, the same way it does for most preventive services.1,2,4

There is one cost boundary worth understanding. The $0 price applies when the test is done as a screening for someone who has no symptoms. If you already have symptoms and the visit becomes a diagnostic workup, or if your provider adds other services during the same visit, normal Part B cost-sharing (the $283 deductible and 20% coinsurance) can apply to those added parts. When you go in specifically for a preventive screening, ask that it be ordered and billed as screening so the $0 rule protects you.2,4

Who Counts as "At Increased Risk"?

Medicare does not publish a fixed checklist for this benefit. Instead, your primary care provider decides whether you are at increased risk based on an honest conversation about your health and history. The U.S. Preventive Services Task Force (USPSTF) supplies the clinical basis: a Grade A recommendation for syphilis screening in people at increased risk, and Grade B recommendations for chlamydia, gonorrhea, and hepatitis B screening and for the counseling.1

Things a provider commonly weighs include a new or additional partner, a partner whose status you are unsure of, or a past infection. The point that matters most is simple: risk is about your situation, not your age. Being over 65 does not disqualify you, and you do not have to label yourself high risk to start the conversation. Tell your provider what is true for you, and let the clinical judgment follow.

The Counseling Visit: Up to 2 Sessions a Year

Alongside the lab tests, Medicare covers high-intensity behavioral counseling (HIBC) to help you prevent STIs. You can have up to two individual, face-to-face sessions a year, each lasting 20 to 30 minutes, provided in a primary care setting and billed under code HCPCS G0445. Like the screening, these sessions cost you $0 when your provider accepts assignment.1

If you have seen older guidance that describes only one counseling visit a year, or a "semiannual" billing label, the current Medicare rule is up to two sessions a year. A session is a real conversation, not a lecture: your provider talks with you about your risk, prevention, and any next steps, which can include a referral for HIV prevention or other services.1

STI Treatment and When You Might Pay

Screening and counseling are preventive services, so they are $0. Treatment is different. If a screening comes back positive, the medicine that treats the infection is covered under Medicare's normal rules, not the preventive benefit. A drug your provider gives you in the office is generally covered under Part B with standard cost-sharing, and a prescription you fill at a pharmacy is covered under your Part D drug plan with its usual copays.2

Part D drug costs have a yearly ceiling. In 2026, once your out-of-pocket spending on covered Part D drugs reaches $2,100, you pay $0 for covered drugs for the rest of the year; that cap was $2,000 when it began in 2025. So even if you need treatment, your total drug cost for the year is capped.5

Related Georgia Medicare Preventive Benefits

STI screening sits inside Medicare's broader set of preventive services, most of which are $0 when your provider accepts assignment. A few related benefits often come up in the same visit:2

• HIV screening is covered separately from the four-test STI panel as its own Medicare preventive service. Part B covers it once a year for eligible beneficiaries, and up to 3 times during a pregnancy, and you pay nothing when your provider accepts assignment. Ask your provider to include it if HIV testing is relevant to you.6
• HIV prevention medicine (PrEP) is also covered by Medicare. Following the 2024 national coverage determination, Part B covers pre-exposure prophylaxis for HIV prevention with no cost-sharing, including FDA-approved oral and injectable PrEP medications, their administration, and related services such as counseling and screenings. People at increased risk of HIV pay no deductible, copayment, or coinsurance for them. PrEP drugs moved from Part D to Part B under that determination.6
• Hepatitis B and hepatitis C screening have their own Medicare coverage. See our Georgia Medicare hepatitis B screening and hepatitis C screening guides.

Getting Screened in Georgia When Your Provider Doesn't Offer It

Not every primary care provider routinely offers STI screening or the counseling visit. If yours does not, you have real options in Georgia:

• Georgia Department of Public Health STD/HIV clinics provide STI screening and treatment, often free or on a sliding scale, regardless of insurance status.
• Federally Qualified Health Centers (FQHCs) build STI screening into routine primary care and are especially important in rural Georgia counties where specialists are scarce.
• The Ryan White HIV/AIDS Program provides comprehensive HIV care in Georgia for people who need help affording it. If you have Medicare and are diagnosed with HIV, Medicare is your primary payer and Ryan White fills gaps such as medication assistance and case management.
• If you have both Medicare and Georgia Medicaid (dual eligible), Georgia Medicaid may cover some STI-related services beyond Medicare, and your out-of-pocket cost for covered care is usually minimal. A GeorgiaCares SHIP counselor can help you sort out which program pays for what.
• GeorgiaCares SHIP gives free, unbiased help with Medicare coverage and billing questions at 1-866-552-4464.3

Contacts and Resources

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Find personalized help navigating Georgia Medicare STI screening and counseling coverage at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.