Does Medicare cover hepatitis shots?

Medicare Part B covers the hepatitis B vaccine if you’re at medium or high risk for the virus. In this case, you’ll receive coverage through Part B as a free preventive service without any deductibles or copayments if your doctor or provider accepts assignment.

Hepatitis B is a contagious liver disease with infection levels ranging from mild illness to serious lifelong infection that can lead to liver failure, liver cancer or cirrhosis, which is permanent scarring of the liver.

The ways you can become infected with hepatitis B differ from how you can contract hepatitis A. They include contact with blood or sores of someone who has hepatitis B, inadvertent needle sticks, poor infection control in health care centers, sex with a partner who has hepatitis B, or sharing contaminated items such as toothbrushes, medical equipment or razors. The CDC recommends the hepatitis B vaccine for all adults 19 to 59 and for adults 60 or older with risk factors.

Medicare Part D covers the vaccine for adults 60 and older if they have low or no known risk factors.

Who is more at risk to get hepatitis B?

Anyone can contract hepatitis B, but some people are at greater risk than others, including anyone:

• Diagnosed with end-stage renal disease.

• In frequent contact with blood or bodily fluids, such as a health care worker.

• Living with someone who has hepatitis B.

• Suffering from hemophilia. 

• Who has diabetes.

Check with your doctor about other factors that may increase your risk for hepatitis B.

Does Medicare cover hepatitis B screenings?

If your primary care doctor orders the test, Medicare Part B will cover hepatitis B screenings once a year when you’re at high risk and aren’t vaccinated. Your doctor can order an initial screening no matter what your vaccination status is. 

For women who qualify for Medicare because of a disability, Medicare will cover hepatitis B screenings if you’re pregnant, first during your prenatal visit and again when you deliver the baby if you have new or continued risk factors. That’s also true for future pregnancy first prenatal visits.

Screenings are covered without any deductibles or copays.

Does Medicare cover hepatitis C screenings?

Yes, Medicare Part B covers screening for hepatitis C, which is spread through contact with blood from an infected person, often by sharing needles or other equipment used to inject drugs.

No vaccine is available for hepatitis C, so screening is vital to identify the virus and treat the disease before it becomes a long-term infection. Your doctor must order the screening for Part B to cover it.

If left untreated, hepatitis C can result in cirrhosis and liver cancer, according to the CDC.

Who is eligible for hepatitis C screening coverage?

You have to meet one or more of the following criteria:

• Had a blood transfusion before 1992.

• Have used or now use illegal injectable drugs.

• Were born between 1945 and 1965.

If you were born from 1945 to 1965 and aren’t considered high risk, Medicare pays for the screening once. If you are high risk, Medicare covers the screening each year.

You pay no deductibles or copayments for the screening if your doctor accepts assignment. 

Keep in mind

Hepatitis strains A, B and C are the most common forms of hepatitis, but you should know about two additional strains.

Hepatitis D is a liver infection that occurs only in people infected with the hepatitis B virus. Similar to other types of hepatitis, hepatitis D can be a short-term illness or become a long-term, chronic infection. No vaccine is available for hepatitis D, but the CDC says the hepatitis B vaccine also protects against future hepatitis D infection.

Hepatitis E is rare and more common in developing countries, especially those with contaminated drinking water. People who have traveled to those countries are at risk. No vaccine is available for hepatitis E, but the CDC says most people fully recover from the disease without complications. 

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