What STD Tests Does ACA Cover?

The Affordable Care Act (ACA) requires health insurance plans to cover certain preventive services, including STD testing, without any cost-sharing (such as copays or deductibles). This means that you should not have to pay anything out-of-pocket for these services.

Which STD Tests Are Covered?

The ACA covers STD testing for the following infections:

HIV (for people under 25)

When Are STD Tests Covered?

STD tests are covered when they are considered preventive, which means they are done to screen for an infection before you have any symptoms. STD tests are also covered when they are done during pregnancy, as they can help to prevent the transmission of infections to your baby.

What If My Insurance Denies Coverage?

If your insurance company denies coverage for an STD test that should be covered, you should appeal the decision. You can do this by writing a letter to your insurance company and explaining why you believe the test is covered. You can also include any documentation from your doctor that supports your case.

Here’s a case example:

Sarah went to her doctor for a pregnancy confirmation visit. Her doctor ordered an STD panel as part of her routine prenatal care. Sarah’s insurance company denied coverage for the STD panel, saying that it was not considered preventive care. Sarah appealed the decision, arguing that the STD panel was necessary to protect her health and the health of her baby. Her insurance company reversed their decision and covered the cost of the STD panel.

How to Avoid Unnecessary STD Testing

To avoid unnecessary STD testing, you should talk to your doctor about which tests are necessary and when they should be done. You can also ask your doctor to use the ICD-10 codes listed above when billing your insurance company for STD tests. This will help to ensure that your insurance company covers the cost of the tests.

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