People who need Medicare coverage for HIV medications and other prescription drugs typically have two options for coverage: enroll in a Medicare prescription drug plan (Medicare Part D) or enroll in a Medicare Advantage plan (Medicare Part C) that covers prescription drugs.
Most prescription medications, including antiretroviral drugs used to treat HIV, are not covered by Original Medicare (Medicare Part A and Part B).
Join our email series to receive your free Medicare guide and the latest information about Medicare and Medicare Advantage.
By clicking "Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
Speak with a licensed insurance agent
Medicare Part A and Part B don’t typically cover any prescription drugs you might buy at a retail pharmacy.
Plan benefits, coverage and availability can vary where you live. Be sure to check with your plan carrier to find out if your HIV medication is covered by your plan and find out what costs may be involved.
Medicare Part B (medical insurance) does cover one HIV screening per year if you’re enrolled in Medicare Part B and meet one of the following conditions:
If your HIV screening is covered by Medicare, you pay nothing for the test if your doctor accepts Medicare assignment. A doctor or health care provider who accepts assignment agrees to accept the Medicare-approved amount as full payment for covered services.
Medicare Advantage plans also cover at least one HIV screening per year based on the above qualifications. Some plans may provide additional HIV-related care services, but they may or may not be available in your area.
A licensed insurance agent can help you look for Medicare Advantage plans in your area that provide the benefits you are looking for, which could include plans that cover HIV medication.
Find Medicare Advantage plans in your areaCompare Plans
Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
Where you've seen coverage of Christian's research and reports: