STI Testing After 50: What Older Adults and Medicare Cover

Short answer: If you're over 50 and have a new partner, more than one partner, or a partner who might have other partners, STI testing is worth asking for. USPSTF recommends HIV screening for older adults at increased risk (USPSTF), and Medicare Part B covers STI screening and counseling for people at increased risk when your provider orders it (Medicare.gov).

Plenty of people start dating again in their 50s, 60s, 70s and beyond. Sex lives don't come with an expiration date, and neither do STIs. The trouble is that screening habits often lag behind. Many older adults last thought about testing decades ago, and some clinicians don't ask about sexual health once a patient is past a certain age. This guide covers which tests apply to you, what Medicare pays for, and how to bring it up without awkwardness.

Why testing still matters after 50

Most STI screening guidelines are written around younger adults because that's where infections are most common. That doesn't mean older adults are exempt. The National Institute on Aging puts it plainly: age doesn't protect you from STIs. It lists syphilis, gonorrhea, chlamydia, genital herpes, hepatitis B, genital warts and trichomoniasis among the infections sexually active older adults can get, and notes that the number of older people living with HIV is growing (NIA).

A few things make later-life dating different:

• Condom habits may be tied to pregnancy. If condoms were mainly birth control for you, it's easy to drop them after menopause or a vasectomy. But menopause ends pregnancy risk, not STI risk. The NIA recommends using a condom for vaginal or anal sex and a dental dam or other barrier for oral sex.
• Many STIs are quiet. Chlamydia and gonorrhea often cause no symptoms, according to CDC's treatment guidelines (CDC). Feeling fine isn't the same as testing negative.
• Symptoms can be misread. Vaginal dryness, irritation or urinary changes after menopause can overlap with infection symptoms. That's a reason to see a clinician, not to guess. Our symptom guide explains why only testing can sort it out.
• Your partner's history is part of yours. A new partner may have had partners you don't know about. That's normal, and it's exactly why testing exists.

What screening guidelines say for older adults

Here's how the main recommendations apply to people over 50. "Increased risk" generally means things like a new partner, more than one partner, a partner with an STI, or a recent STI diagnosis. Your clinician will weigh your situation.

A few details are worth knowing. The USPSTF HIV recommendation names people 15 to 65 for routine screening and says younger adolescents and older adults at increased risk should also be screened (USPSTF). For hepatitis C, USPSTF recommends screening adults 18 to 79 (USPSTF), and CDC recommends at least one test for every adult (CDC). CDC also recommends hepatitis B screening at least once for all adults, using a three-test panel (CDC). Our hepatitis B and C testing guide explains what those blood tests measure.

For chlamydia and gonorrhea, USPSTF's routine screening recommendation is for sexually active women 24 and younger and for older women at increased risk; it found too little evidence to recommend routine screening in men (USPSTF). That's about routine screening. If you've had a specific exposure or a partner tells you they tested positive, testing is a reasonable step at any age. Syphilis screening is recommended for adults at increased risk (USPSTF).

What Medicare Part B covers

Medicare treats several of these tests as preventive services. That usually means you pay nothing for the test itself if your provider accepts assignment. Check the specific page for each service, because the rules differ.

Two conditions are easy to miss. Your health care provider has to order the STI screening (or refer you for counseling), and the counseling sessions are covered only in a primary care setting, such as a doctor's office (Medicare.gov). You pay nothing for these services if your provider accepts assignment. HIV screening rules are on Medicare's HIV screening page, and hepatitis C rules are on its hepatitis C screening page.

If you have a Medicare Advantage plan, network rules can differ. Call the number on your card and ask which providers you can use for preventive screening.

How to ask your doctor without awkwardness

Many clinicians wait for patients to bring it up. You don't need to explain your dating life in detail. Something short works:

If they ask follow-up questions, answer what you're comfortable with. The useful facts are:

1. Timing: roughly when your most recent new exposure was, so the test isn't done too early. See window periods.
2. Body sites: whether sex was oral, vaginal, anal, or a mix, so the right samples get taken.
3. Symptoms: anything new, like sores, discharge, burning, or a rash.
4. Past testing: whether you've ever had HIV, hepatitis B or hepatitis C testing.

After the visit, check your patient portal for each test by name. A routine blood panel isn't an STI panel, as our guide on whether an annual physical includes STI testing explains.

Other ways to get tested

Going through your primary care provider is usually the cheapest route on Medicare. But some people would rather not discuss it with a doctor they've known for years, or want results sooner. Options include:

• Local health departments and sexual health clinics. Many offer free or low-cost testing. CDC's GetTested finder lists sites by ZIP code.
• Online-ordered lab tests. You order online and give a sample at a lab. These are often self-pay, so don't assume Medicare will cover them. Check the provider's insurance policy first.
• At-home kits. Mail-in kits and HIV self-tests exist. See our comparison of same-day lab tests vs mail-in kits.

Affiliate link: we may earn a commission at no extra cost to you. Free options are listed above.

If you think you were exposed to HIV recently

For ongoing prevention, PrEP is an option for adults of any age who could be exposed to HIV. Our sister site FreePrEP.org explains low-cost ways to get it.

A simple plan for dating after 50

1. Get your baseline. If you've never had HIV, hepatitis B or hepatitis C testing, ask for it. CDC recommends hepatitis B and C screening at least once for all adults.
2. Test when something changes. A new partner, more than one partner, or a partner with an STI are reasons to test. Our guide on how often to test with new or multiple partners covers timing.
3. Use the Medicare benefit. Ask your primary care provider to order screening so it's covered as preventive care.
4. Talk with partners. Sharing recent results is a normal part of dating at any age. Our new partner checklist can help.
5. See a clinician for symptoms. Sores, discharge, pain or a rash need an exam, not just a screening panel.

Disclaimer: This article is for informational purposes only and does not diagnose, prescribe, or replace individualized medical care. Testing and treatment decisions should be made with a qualified healthcare provider. Some links on this page are affiliate links; we may earn a commission at no extra cost to you.