Hepatitis C is a virus that attacks the liver and can cause chronic liver disease. Screening can help determine if you need medical treatment for hepatitis C.
Medicare Part B covers one hepatitis C screening if your primary care provider (PCP) orders the test for you, and you:
- Were born between 1945 and 1965
- Had a blood transfusion before 1992
- Or, are considered high risk due to current or past history using federally prohibited, injectable substances
Note: If you are considered at high risk for hepatitis C, you also qualify for yearly screenings following the initial screening.
If you qualify, Original Medicare covers hepatitis C screenings at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover a hepatitis C screening without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
During the course of your screening, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.
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