heptatitis c

Does Medicare Cover Hepatitis C Treatment?

The treatment for hepatitis C can get expensive if your insurance doesn’t help cover the costs. What if you are on Medicare and don’t have any other options?

What is hepatitis C?

Hepatitis C is a liver infection that stems from the hepatitis C virus. There are different forms of the virus. The most common form in the United States is type 1.

Each form of the virus is the about the same when it comes to how serious it can be, but they require different treatments due to their responses.

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What is the treatment?

If you have been diagnosed with hepatitis C, it is important to talk to your healthcare provider about what your options are. Since it can vary, so can the treatment options. If your case is mild, you may have coverage under Medicare Part B with outpatient services.

A doctor may also prescribe a medication to help with treatment. Medicare does not cover most of the prescriptions that are used to treat hepatitis C, except in special inpatient and outpatient situations.

Medicare Part D will cover certain prescription drugs in the special situations.

What does Medicare cover?

First, Medicare covers a single screening test as long as you meet at least one of these conditions:

  • High risk from illicit drug use
  • Born between 1945-1965
  • Had a blood transfusion before 1992

If you are deemed as a high risk, Medicare will cover an annual screening.

Medications for hepatitis C

Medicare plans all have a prescription drug coverage formulary that lists medications which are covered and what their prices are. A Medicare Advantage prescription drug plan or stand-alone Medicare Prescription drug plan may change its formulary at any time, but the plan must give you a 60-day written notice.

You can check your Medicare prescription drug plan options and the medications that are covered by using the Find Plans tool here.

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