Hepatitis C is one of the most common forms of Hepatitis, an inflammation of the liver caused by a virus. Acute infections usually occur within six months of exposure to the disease, and can lead to short-term illness. Most cases of Hepatitis C develop into a longer and possibly lifelong condition. Left untreated, chronic Hepatitis C can lead to liver damage, cirrhosis of the liver, and is the most common cause of liver cancer and liver transplants.

According to the Centers for Disease Control & Prevention (CDC), over 2 million people live with chronic Hepatitis C. Baby Boomers are five times more likely to contract Hepatitis C. With so many boomers receiving Medicare benefits or approaching eligibility, coverage of screenings and treatment can lead to a cure for many seniors.

Screenings for Hepatitis C

Hepatitis C is usually spread by blood through needles or syringes used to inject drugs, but it can be transferred through sexual contact.  Medicare will cover the cost of one screening for Hepatitis C if you meet the following criteria:

  • You are high risk due to illicit injected drugs
  • You had a blood transfusion before 1992
  • You were born between 1945 and 1965

If you’re considered high risk, Medicare will cover yearly screenings. Why would you be considered high risk?

  • You work in the medical field and come in contact regularly with blood.
  • You are on dialysis.
  • You have HIV or other sexually transmitted disease.
  • You have a family or household member with the disease.

Your health care provider must order the screenings and accept assignment for Medicare to cover the costs.

Medicare Part D Can Help

If you are diagnosed with Hepatitis C, your doctor will speak to you about treatment options. There are several new medications that have been introduced to treat chronic Hepatitis C. Current treatments include oral medication, sometimes called direct-acting antivirals. These medications can be taken for approximately 8-12 weeks with a 90% rate of curing Hepatitis C.

If you require prescription medications for treatment of Hepatitis C, you can get help paying for them by enrolling in Medicare Part D. If you have Original Medicare, you can enroll in a stand-alone Prescription Drug Plan (PDP), or you can enroll in a Medicare Advantage plan with prescription drug coverage (MA-PD). Each PDP or MA-PD can have its own formulary, or list of covered drugs, and tiers of pricing. Costs can vary based on whether you take generic or brand-name drugs, and whether you get your medication from an in-network pharmacy or through mail order.  Compare plans before enrolling to make sure your insurance will cover the drugs you need to treat Hepatitis C. If you are enrolled in a plan but your needs have changed over the past year, you can make changes to your Medicare coverage during the Annual Election Period, from October 15 through December 7.

Related articles:

Medicare Part D: Medicare Prescription Drug Coverage

What is the Medicare Annual Election Period (AEP)?