Does Medicare Cover Hep C Testing?

Medicare typically covers Hepatitis C testing one time if you meet certain specific conditions. Medicare Advantage plans may also cover Hep C testing in specific patient populations, and many Medicare Advantage plans also cover prescription drugs.

Medicare typically does cover Hepatitis C testing one time if you have risk factors that put you at a high risk for getting Hepatitis C.

Medicare Advantage (Part C) plans may also cover Hep C testing that meets eligible criteria and is ordered by a doctor. Many Medicare Advantage plans also cover prescriptions drugs, which Original Medicare (Part A and Part B) doesn’t cover.

A doctor reviews information with a patient

How does Medicare cover Hepatitis screenings?

Hepatitis C is a viral infection that can lead to serious liver damage if untreated. Medicare Part B may cover one-time Hep C testing for patients who are at high risk of contracting the virus.

You are considered high risk if you meet one or more of the following criteria:

  • You use or have used illicit injected drugs
  • You had a blood transfusion earlier than 1992
  • You were born between 1945-1965

If you are considered at risk for Hep C, Medicare Part B will also cover yearly screenings to check on your health compared to your initial Hep C test.

Medicare Part B may also cover Hepatitis B Virus (HBV) screening if you’re at high risk for HBV or if you’re pregnant.

How much does a Hep C test cost with Medicare?

If Medicare covers your Hep C test – and if you visit a health care provider who accepts Medicare assignment – you pay nothing for your Hepatitis C screening. If a doctor accepts Medicare assignment, it means they accept Medicare reimbursement as full payment for their services.

Speak with your doctor for direct cost and coverage information.

Many Medicare Advantage plans may also cover prescription drugs

Medicare Advantage plans are sold by private insurance companies as an alternative to Original Medicare. Medicare Advantage plans are required to offer the same benefits as Original Medicare.

This means that if your Hep C test is covered by Original Medicare, it will also be covered by a Medicare Advantage plan.

Many Medicare Advantage plans may also offer prescription drug coverage.

Some plans may offer additional benefits like routine dental care and vision care, as well as home meal delivery and free gym memberships.

To learn more about how a Medicare Advantage plan may cover your Hep C testing and to find plans in your area, call to speak with a licensed insurance agent and find out if you’re eligible to enroll today.


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