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Does Medicare Cover Hepatitis C Treatment?

Hepatitis C stock photo
By Daniel Petkevich
Nov 22, 2022

Read on to see how you might be covered

The treatment options for those with a Hepatitis C infection have improved rapidly. Medicare covers both the screening test and your drug treatment options. If push comes to shove, Medicare will also cover the liver transplant. Medicare covers each aspect of treatment differently, but you will have coverage. Let's dig into how Medicare covers Hep C.

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How does Medicare cover Hepatitis C screening?

Medicare covers one screening test for people who are at risk of having Hepatitis C. The factors Medicare uses to determine if you are high-risk include the following:
  • Those who have injected drugs,
  • Those who received a blood transfusion prior to 1992, or
  • Those born between 1945 and 1965.
Additionally, if you have abnormal liver function tests or symptoms that suggest you may have an infection, Medicare will cover the cost of a screening test. No matter the reason, if your doctor orders you to have a screening test, you won't have to pay.

How does Medicare cover Hepatitis C treatment?

Depending on your coverage, Medicare may cover medications like Harvoni, Vosevi, Epclusa, and Sovaldi. Regardless of what prescription drug treatment you are taking, all Medicare Advantage plans and standalone Part D prescription drug plans have a requirement that they must cover at least one medication that treats Hep C.

Does Medicare cover liver transplants?

Yes, in some cases. If you need a life-saving liver transplant as part of your Hepatitis C treatment, this will likely be covered by Part A since you will be admitted to the hospital for an in-patient procedure. For in-patient procedures, you're responsible for your Part A deductible. Once you are released to outpatient work, you are responsible for 20% of the total cost, or less, depending on your plan.

Conclusion

Medicare covers several aspects of Hepatitis C treatment, including screening tests, drug treatments, and in some cases, a life-saving liver transplant. Before making any decisions about your care or coverage, be sure to consult with your healthcare provider and Medicare plan to determine what is best for you. This content is for informational purposes only. If you have any questions or concerns about your Medicare options, call our Medicare experts today at 888-376-2028.

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Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

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