Does Medicare cover the hepatitis B vaccine?

What does Medicare cover for the hepatitis B vaccine?

Medicare Part B covers hepatitis B vaccines as a preventive service if you're eligible. Hepatitis B vaccines help protect against the hepatitis B virus (HBV). Medicare.gov lists hepatitis B vaccines with the COVID-19, flu and pneumococcal vaccines among the vaccines Part B covers.

Who qualifies for the hepatitis B vaccine under Medicare?

To get the hepatitis B vaccine covered by Part B, you must meet at least one of these conditions:

• You've never gotten a complete series of hepatitis B vaccines.
• You don't know your vaccination history.
• You have a health condition or situation that puts you at medium or high risk for hepatitis B, like diabetes, End-Stage Renal Disease (ESRD) or living with someone who has hepatitis B.

What puts me at risk for hepatitis B?

Medicare.gov says your hepatitis B risk increases if one or more of these conditions applies to you. For kidney failure coverage, see Medicare with kidney failure.

• You have hemophilia (a genetic bleeding disorder that keeps your blood from clotting properly) and you get factors VII or IX.
• You have End-Stage Renal Disease (ESRD), permanent kidney failure that requires a regular course of dialysis or a kidney transplant.
• You have diabetes.
• You live with someone who has hepatitis B.
• You're a health care worker and have frequent contact with blood or bodily fluids.

What do I pay for the hepatitis B vaccine?

You pay nothing if your doctor or other health care provider accepts assignment for giving the vaccine. Assignment means your provider agrees to be paid directly by Medicare, to accept the payment amount Medicare approves, and not to bill you for more than the Medicare deductible and coinsurance.

Medicare.gov suggests asking your doctor or other health care provider how much a service will cost, because a doctor may recommend services that Medicare doesn't cover or offers too frequently. Specific amounts you could owe depend on other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and where you get the service.

Does Medicare cover hepatitis B screening too?

Yes, Part B covers a hepatitis B virus (HBV) infection screening if your doctor or other health care provider orders one and you're at high risk for HBV infection or you're pregnant. You pay nothing if your provider accepts assignment.

Part B covers the screening once a year if you're at continued high risk and don't get a hepatitis B vaccine. If you're pregnant, Part B covers it at your first prenatal visit and at the time of delivery if you have new or continued risk factors, even if you previously got the hepatitis B vaccine or had negative HBV screening results.

Does Medicare Advantage change hepatitis B vaccine coverage?

A Medicare Advantage Plan must give you at least the same coverage as Original Medicare, but the plan may have different rules. See how Medicare Advantage differs from Original Medicare.