Medicare coverage of hepatitis B shots

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Hepatitis B is the most widespread of the hepatitis viruses.

If you are at medium to high risk for hepatitis B, there is no coinsurance or deductible for the hepatitis B vaccine if you have Medicare Part B and use providers who take assignment. Doctors and other health care providers who take assignment cannot charge you more than the Medicare approved amount.

People who are considered high or medium risk for hepatitis B are:

  • Those with End-Stage Renal Disease (ESRD) also known as kidney failure
  • Hemophiliacs
  • Clients and staff at institutions for the developmentally disabled
  • Those who live in the same household as an hepatitis B carrier
  • Homosexual men
  • Illicit drug users
  • Health care professionals who have frequent contact with blood or other body fluids during routine work  

Medicare Advantage plans will cover all preventive services the same as Original Medicare. If you are in a Medicare Advantage plan and not at medium to high risk for hepatitis B, you may have to pay a copay for this vaccine. You should contact your plan to find out what costs and rules apply. Your costs will also vary depending on whether you use an in-network or out-of-network provider to administer the injection. 

If you are at a low-risk for hepatitis B, the shot will be covered under Part D.  


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LINKS
Medicare.gov -- Search for Participating Physicians

American Liver Foundation

Centers for Disease Control and Prevention - Traveler's Health

American Kidney Fund

National Forum of End-Stage Renal Disease (ESRD) Networks

National Institute of Diabetes and Kidney Diseases (NIDDK)

National Directory of Medicare Regional Carriers and Intermediaries

Medicare.gov: National A/B MAC Information

 
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