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Does Medicare Cover UTI treatment?

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What is a UTI?

According to the Centers for Disease Control and Prevention (CDC) a urinary tract infection (also called UTI) is an infection involving any part of the urinary tract including:

  • Bladder
  • Kidneys (two bean-shaped organs that filter blood and produce urine)
  • Ureters (tubes that carry urine from the kidneys to the bladder)
  • Urethra (the tube that allows urine to pass out of the body. In men the urethra is long; in women the urethra is short)

What causes a UTI?

According to the Mayo Clinic, a UTI is caused by bacteria entering the urinary tract through the urethra and multiplying. Usually the urinary system can defend itself against bacteria but sometimes these defenses fail.

Female anatomy is a risk factor for a UTI. According to the U.S. National Library of Medicine, about four times as many women get UTIs as men. Since the female urethra is shorter than a male’s, there is a shorter distance for bacteria to travel to reach the bladder, according to the Mayo Clinic.

Sexual activity is also a risk factor for UTIs for women, as is menopause.

UTIs are the most common type of healthcare-associated infection, according to the CDC. That means that prolonged use of a urinary catheter is a risk factor for developing a catheter-associated UTI. A doctor may recommend a catheter, or tube to drain the bladder, for certain health conditions, such as surgery on the prostate or genitals or urinary incontinence, according to the U.S. National Library of Medicine. The CDC recommends that catheters are removed as soon as they are no longer needed.

What are the symptoms of a UTI?

The symptoms of a UTI vary according to the location of the infection, according to the Mayo Clinic

A kidney infection could result in:

  • Upper back pain
  • High fever
  • Shaking and chills
  • Nausea and vomiting

A bladder infection could result in:

  • Pelvic pressure
  • Frequent, painful urination
  • Blood in the urine

A urethra infection could result in:

  • Burning with urination
  • Discharge

Urine that smells bad or looks cloudy may also be a sign of a UTI, according the U.S. National Library of Medicine.

What is UTI Treatment?

The Mayo Clinic recommends contacting your doctor if you have signs or symptoms of a UTI. Complications of a UTI could include permanent kidney damage or sepsis, which is a life threatening condition.

Your doctor may first ask for a urine sample before beginning UTI treatment, according to the Mayo Clinic. Antibiotics are used for UTI treatment. Often symptoms can clear up within a few days of UTI treatment. However, you may need to take antibiotics for a week or more and you must take the entire course of antibiotics as prescribed.

To get coverage for antibiotics and other prescription drugs for UTI treatment, you generally need Medicare Part D prescription drug coverage. You can get Medicare Part D through:

  • A stand-alone Medicare Part D Prescription Drug Plan to go alongside your Medicare Part A and Part B
  • A Medicare Advantage plan with prescription drug coverage.

All Medicare prescription drug coverage is offered through private insurance companies contracted with Medicare.

For a severe infection, you may need to receive UTI treatment with intravenous antibiotics in the hospital, according to the Mayo Clinic. Your inpatient hospital stay will generally be covered by Medicare Part A. For Medicare Part A you pay a $1,340 deductible in 2018 and $0 coinsurance for days 1-60 in the hospital.

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