Does Medicare Cover SIBO Testing?

By Daniel Petkevich

Dec 1, 2022

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Read this before you buy a SIBO test

Medicare offers coverage for many different tests and treatments. Unfortunately, a SIBO test is not one of the tests covered by Medicare. So what options do you have instead? Let's find out.

What is SIBO?

SIBO, or Small Intestinal Bacterial Overgrowth, is a condition in which bacteria that are usually found in the large intestine (colon) overgrow and migrate to the small intestine. This can cause symptoms like abdominal pain, bloating, gas, constipation and/or diarrhea.

How is SIBO diagnosed?

SIBO is typically diagnosed with a breath test that measures the amount of gas produced by bacteria in your small intestine. This type of testing is simple and non-invasive and can provide an accurate diagnosis of SIBO.

Does Medicare cover SIBO testing?

Unfortunately, Medicare does not currently cover SIBO testing. Medicare does not consider it medically necessary and, therefore, will not cover the cost of testing.

If you have questions about your specific insurance plan and what it covers, it is best to contact the provider directly. You may also be able to use out-of-pocket funds for this test. Speak with your doctor about the best option for you.

How much is a SIBO test?

The cost of a SIBO test can vary depending on where you get it done and which type of test is used. Generally, the price ranges from $250 to $600.

If you think you may have symptoms of SIBO, speak with your doctor about the best testing option for you. They will be able to help you get started and recommend treatment.

What are the treatment options for SIBO?

If your SIBO test is positive, your doctor will likely recommend a combination of dietary changes and antibiotics to help manage the condition. These treatments are not typically covered by Medicare either, but you may be able to use out-of-pocket funds if you don’t have other insurance coverage. Some Medicare Advantage plans offer stipends to help with costs such as these. Check with your plan provider to see how you could help treat your SIBO.

How can you prevent SIBO from happening in the first place?

Though there is no guarantee that you can entirely prevent SIBO, there are steps you can take to reduce the risk of developing it. These include the following:

Probiotics may also be helpful in reducing your risk of SIBO.

If you have any further questions about SIBO or its treatment options, it’s best to speak with your healthcare provider for more information and personalized advice.

Conclusion

If you suspect that you have SIBO and need medical care, it is important to speak with a healthcare provider to discuss diagnosis and treatment options. Although Medicare does not cover SIBO testing, there are still options available to help accurately diagnose this condition. For testing and treatment, remember to speak with your doctor first. This content is for informational purposes only. Call one of our Fair Square Medicare experts today for any questions about your Medicare plan.