Quick Answer
Yes. Medicare Part B covers hepatitis C screening at no cost to you when your doctor orders it as a preventive service. Adults born between 1945 and 1965 are covered once in a lifetime. Adults at increased risk - such as those with a history of injection drug use or certain blood transfusions before 1992 - are covered once per year. There is no copay or coinsurance when you see a participating provider.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare (Part A & B) | Covered | $0 cost for eligible beneficiaries when ordered as a preventive service by a participating provider |
| Medicare Advantage (Part C) | Covered | Must cover all Medicare-required preventive services at $0 cost-sharing |
| Medicare Supplement (Medigap) | No Cost-Sharing Needed | No out-of-pocket cost for the screening itself; Medigap is not needed for this service |
| Medicare Part D | May Cover Treatment Rx | If hepatitis C is detected, antiviral medications may be covered under Part D |
Understanding Your Coverage Options
Original Medicare (Part a & B)
Medicare Part B covers hepatitis C screening as a preventive service at no cost to you. You qualify if you were born between January 1, 1945 and December 31, 1965 (covered once in a lifetime), or if you are at increased risk due to a history of injection drug use, certain blood transfusions before 1992, or other risk factors your doctor identifies (covered once per year).
There is no deductible or coinsurance for this screening when your doctor orders it as a preventive service and you see a participating provider. If the screening leads to additional diagnostic testing, standard Part B cost-sharing may apply.
Medicare Advantage (Part C)
Medicare Advantage plans are required to cover all Medicare-mandated preventive services, including hepatitis C screening, at $0 cost-sharing when you use an in-network provider. Some plans may offer additional screenings or follow-up support.
Medicare Supplement (Medigap)
Because the hepatitis C screening itself has no cost-sharing under Original Medicare, a Medigap plan is not needed to cover the screening. However, if a positive result leads to follow-up diagnostic tests or treatment, Medigap can help cover the Part B coinsurance for those services.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.