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Medicare Coverage for Hepatitis Screenings, Vaccines, and Treatments

Fortunately, Medicare helps to protect seniors from hepatitis by covering necessary vaccines and treatments. When it comes to treatments and vaccines, several options are available, depending on what is medically necessary for you.

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Below we will answer the question; Does Medicare cover the hepatitis A vaccine? What coverage does Medicare offer for hepatitis B or hepatitis C?

Is the Hepatitis B Vaccine Covered by Medicare?

Transmission of hepatitis B most commonly occurs via exposure to an infected individual’s blood or bodily fluids. The vaccine to prevent hepatitis B is a series of three shots over six months.

Medicare Part B outpatient coverage pays for the hepatitis B vaccine if you are unvaccinated and at risk of contracting the virus.

Risk factors to receive the vaccine include the following:

When receiving the vaccine, if your provider accepts Medicare assignment, you may not be responsible for any out-of-pocket costs.

However, if none of the above apply to you, but you believe you are still at risk, check with your doctor, as you may be at medium risk and still eligible for the vaccine. If not, you may be responsible for a small copayment.

Does Medicare Cover Hepatitis C Treatment?

Although there is no vaccination against hepatitis C, the good news is that it can be cured through a treatment process.

The treatment for hepatitis C involves drug therapy. Medicare Part D and Medicare Advantage plans that include prescription drug coverage will pay for drug therapy.

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You may need prior authorization from your physician before starting treatment. However, treatment has seen high effectiveness rates in the past.

Refer to your drug formulary if you need medication to treat a hepatitis C infection. Every Medicare Part D plan must include at least one medication that treats hepatitis C. So if your plan’s formulary does not cover the drug you need, other options may be available.

However, this does not mean that the costs of the medications are low. During the Annual Enrollment Period, you can investigate new plan options that might provide better coverage for your prescription.

Will Medicare Pay for a Hepatitis C Vaccine?

Hepatitis C is contracted in the same manner as hepatitis B. Unfortunately, there’s no vaccine yet to help prevent this type.

Yet, Medicare Part B provides coverage for a one-time hepatitis C screening if you:

  • Have a date of birth between the years 1945 and 1965
  • Received a blood transfusion before 1992
  • Have used or currently use illegal drugs via injection

For those who are high-risk, Medicare Part B covers an annual screening for hepatitis C. Qualifying screenings receive full coverage.

Does Medicare Cover a Hepatitis A?

Hepatitis B and hepatitis C are the most common types in the United States. However, hepatitis A can also negatively affect the liver and, thus, cause serious health problems.

This type of hepatitis is often spread through microscopic particles of infected fecal matter in food or beverages. Usually, this happens when the person who prepared the food hasn’t washed their hands after using the restroom.

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A vaccine against hepatitis A is available and receives coverage from Part D prescription drug plans. Medicare Advantage plans that include a prescription drug component also cover it.

Medicare Part A or Part B may cover the vaccination administration, depending on where it takes place – in an inpatient setting, such as a skilled nursing facility, or an outpatient doctor’s office.

FAQs

Does Medicare cover hepatitis B screenings?
If the beneficiary is high-risk, unvaccinated, or pregnant, hepatitis B screenings receive full coverage when the provider accepts Medicare assignment.
What is considered a moderate risk by Medicare for hepatitis B screenings?
If you aren’t high-risk but think you would benefit from the hepatitis B vaccine, speak to your doctor. They will determine whether you are at moderate risk, qualifying you for 100% vaccine coverage through Medicare Part B.
Does Medicare cover the cost of a one-time hepatitis C screening?
Medicare Part B covers 100% of the cost of a one-time hepatitis C screening for those who qualify.

How to Get Help with Medicare Coverage for Hepatitis

Many parts of Medicare offer coverage for the prevention and treatment of the three types of hepatitis. We understand that Medicare coverage can be difficult, and we’re here to help ensure you’re informed and have the right coverage in the event of the unexpected.

When it comes to having the best prescription drug coverage to pair with your Medicare benefits, our agents are here for you. Call the number above to speak to an agent about plans in your area. Or, fill out our online rate form to see a plan comparison and let us help you choose the right fit for your health and budget needs.

Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare guru serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

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