Medicare, the government-run insurance program that covers some 44 million Americans, will now pay for beneficiaries’ HIV tests. Federal regulators made the announcement Tuesday, December 8.
A federal law passed in 2008 gives the Centers for Medicare and Medicaid Services the authority to cover additional preventive services, so long as the coverage has a substantial impact on beneficiaries’ health. Early detection and treatment of HIV is critical to ensuring infected individuals’ wellbeing over time, justifying the Centers’ move. High risk beneficiaries, including pregnant women and gay men, will be covered, as well as any beneficiary who specifically requests the test.
Medicare is now primarily accessed by people over the age of 65, but that may change with health care reform. The Senate is currently considering a version of the “public option” that extends Medicare to people aged 55 and older. These people would have to pay premiums for their coverage, unlike traditional Medicare beneficiaries aged 65 and older.
People over the age of 50 now account for a larger and larger share of the HIV+ and at-risk population. In 2005, this group accounted for 24% of all people living with HIV/AIDS, a jump from 17% in 2001. This is in part due to the success of HIV treatments, allowing infected individuals to live longer and healthier lives. But this fact doesn’t entirely account for new HIV infections among the 50+ population. In 2005, 15% of all new HIV diagnoses were among people 50 and older. As with their younger counterparts, people in their 50s and older are sexually active, use drugs, and are exposed to HIV in other ways.
Gay, bisexual and men who have sex with men (MSM) continue to account for the largest share of new infections overall (53%); most older gay, bi and MSM are White. In fact, Black and Latino gay, bi and MSM are far more likely to contract HIV as young people, and are infected at higher rates than their White counterparts more generally, while White gay, bi and MSM are mostly becoming infected in middle age.
All of which points to the fact that increasing the availability of testing for all age groups and in particular for certain target populations should be a top priority in the fight against HIV/AIDS. AIDS Action Committee’s MALE Center has tested over 800 individuals in the last year at its South End, Boston location. A primary goal of the MALE Center is to bridge the gap between younger and older gay, bi and MSM, with social and community groups designed to serve both ends of the age spectrum. Other efforts are in development to address the needs of the older HIV+ positive and at-risk population.
As the HIV/AIDS services community continues to develop new ways to reach people over 50, Medicare testing coverage is a good, first step towards reducing infection rates and getting those infected into proper care. But as infection rates show, especially among gay, bi and MSM, testing coverage and routine testing are not going to reduce infection across the board.