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Medicare Coverage for Hepatitis Screenings, Vaccines, and Treatments


Viral hepatitis is a condition that inflames the liver. It’s contagious and causes over a million deaths each year. Fortunately, Medicare helps to protect recipients from hepatitis. But what do they pay for? We’ll go over which preventions and treatments for Hepatitis A, B, and C obtain coverage.

Does Medicare Pay for the Hepatitis B Vaccine?

Hepatitis B is most often transmitted when exposed to bodily fluids or blood from an individual infected with the virus. The vaccine to prevent Hepatitis B is a series of three shots over six months. Part B provides coverage for the Hepatitis B shots if you’re unvaccinated and at risk of contracting the virus.

Risk factors include the following:

  • Hemophilia
  • ESRD
  • Diabetes
  • Living with someone who has Hepatitis B
  • Working in health care, where you frequently have contact with bodily fluids or blood

You won’t owe any payment if your provider accepts Medicare assignment. If none of the above apply to you, but you believe you’re still at risk, check with your doctor, as you may be at medium risk.

Does Medicare cover Hepatitis C Screening?

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

Yet, 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 use, illegal drugs via injection

For those who are high-risk, Part B covers a screening annually. Qualifying screenings receive full coverage.

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. Part D and Advantage plans that include prescription drug coverage will cover drug therapy. You may need prior authorization from your physician before starting treatment.

If you need medication to treat a Hepatitis C infection, refer to your drug formulary. Every Part D plan is required to include a medication that treats Hepatitis C.

Yet, this doesn’t mean that the costs for the medications are low. During the Annual Enrollment Period, you can look into new plan options that might provide better coverage for your medication.

Does Medicare Cover a Hepatitis A Vaccine?

Hepatitis B and C are the most common types in the United States. However, Hepatitis A can also negatively affect the liver and, thus, cause health problems. This type of hepatitis is most often spread through microscopic particles of infected fecal matter in food or beverages. Usually, this happens when the person who prepared food hasn’t washed their hands after using the restroom.

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

Part A or B may cover the vaccination administration, depending on if 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 and unvaccinated or pregnant, Hepatitis B screenings receive full coverage when the provider accepts assignment.
What is considered a moderate risk for Hepatitis B for Medicare?
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, which will qualify you for 100% coverage of the vaccine.
Does Medicare cover the cost of a one-time Hepatitis C screening?
For those who qualify, Part B covers 100% of the cost of a one-time Hepatitis C screening.

How to Get Help with Medicare Coverage for Hepatitis

As you can see, many parts of Medicare offer coverage for the prevention and treatment of hepatitis. We know this is difficult, and we’re here to help ensure you’re informed and have the right coverage.

When it comes to having the best prescription drug coverage, 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 rates form to see a plan comparison and help you choose the right fit for your health and budget needs.

Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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