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Medicare adds HIV screening coverage

As of January 1, 2010, all Medicare Advantage plans cover HIV testing for Medicare beneficiaries who are at risk or who are pregnant.

Both the standard and US Food and Drug Administration (FDA)-approved (HIV) rapid screening tests are covered.  Testing for HIV, the human immunodeficiency virus that causes AIDS, is completely voluntary.

When the screening test is covered

Annually for Medicare beneficiaries at increased risk for HIV infection per U.S. Preventive Services Task Force guidelines, including:

  • Men who have had sex with men after 1975;
  • Men and women having unprotected sex with multiple partners;
  • Past or present injection drug users;
  • Men and women who exchange sex for money or drugs, or have sex partners who do;
  • Individuals whose past or present sex partners were HIV-infected, bisexual or injection drug users;
  • Persons being treated for sexually transmitted diseases;
  • Persons with a history of blood transfusion between 1978 and 1985;
  • Persons who request an HIV test despite reporting no individual risk factors, since this group is likely to include individuals not willing to disclose high-risk behaviors.

When you are pregnant, during the third trimester, and at labor.


These voluntary tests are covered under the lab services benefit on all Priority Heath Medicare Advantage plans. Please see the Evidence of Coverage booklet for details on your lab benefit.

See the PriorityMedicare Value plan Evidence of Coverage booklet (1.7MB PDF, see page 52)
See the PriorityMedicare plan Evidence of Coverage booklet (1.7MB PDF, see page 52)
See the PriorityMedicare Plus plan Evidence of Coverage booklet (1.7MB PDF, see page 52)
See the PriorityMedicare Choice plan Evidence of Coverage booklet (1.7MB PDF, see page 53)


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