Does Medicare Cover the Hepatitis A and Hepatitis B Vaccines?
Both Hepatitis A and Hepatitis B are viral infections that affect the liver. The word “hepatitis” means liver inflammation, referring to a common symptom of Hepatitis A and B. Although it’s not as common as it used to be, contracting these viruses can lead to serious complications, especially in older adults with pre-existing conditions.
You can protect your liver with the Hepatitis A and Hepatitis B vaccine. Medicare covers both of these vaccines in different ways. We’ll show you how Medicare Part B and Medicare Part D cover these vaccines and any eligibility requirements you need for them.
Key takeaways:
Hepatitis A and Hepatitis B are both viral infections that affect the liver, but have different impacts on your health.
Medicare Part B covers the Hepatitis B vaccine if you’re at high risk for infection.
Medicare Part D covers the Hepatitis A and Hepatitis B vaccines if you’re at low risk of infection.
What is Hepatitis A and Hepatitis B?
While Hepatitis A and Hepatitis B are both viral infections that affect the liver, they differ in how they’re transmitted, virus types, and long-term impacts.
Hepatitis A is caused by the hepatitis A virus (HAV). Hepatitis B is caused by the hepatitis B virus (HBV). Here’s a table to show how they compare and what makes them different.
| Characteristic | Hepatitis A | Hepatitis B |
|---|---|---|
| Transmission method | - Food contamination - Personal contact with contaminated person | - Exposure to infected bodily fluids (e.g., from mother to baby at birth, through unprotected sexual contact, or via unsterile needle contact or blood transfusions) |
| Severity of infection | - Typically less severe - Symptoms clear within a few weeks to months - Doesn't cause chronic liver disease | - Can be mild or severe - Can cause chronic conditions and complications if virus remains in body |
| Treatments | - Support and care to relieve symptoms over time | - Supportive care - Antiviral medications for chronic Hepatitis B - Regular monitoring for chronic conditions |
| Long-term impact | No chronic infection, symptoms usually resolve eventually | May require long-term management for chronic infection |
Hepatitis B tends to be more serious than Hepatitis A if left untreated. In serious cases, chronic Hepatitis B can lead to cirrhosis, liver failure, and liver cancer.
Both viral infections share common symptoms, like:
Fever
Fatigue
Loss of appetite
Nausea and vomiting
Abdominal pain
Dark urine
Light colored stools
Joint pain
Jaundice (yellowing of the skin and eyes)
Thankfully, both Hepatitis A and Hepatitis B can be prevented by getting vaccinated.
Does Medicare cover the Hepatitis A and Hepatitis B vaccine?
In most cases, Medicare Part B or your Medicare Part D prescription drug coverage will cover Hepatitis vaccinations. Which Part of Medicare provides coverage depends on which vaccine you need and your level of risk.
Medicare and the Hepatitis B vaccine
As part of its services for preventive coverage, Medicare Part B covers Hepatitis B for people who are at medium or high risk of infection. You qualify for Part B coverage of the shot if you meet at least one of the following conditions.
You have hemophilia and you receive factors VIII or IX (replacement therapy) for treatment
You have End-Stage Renal Disease (ESRD)
You have diabetes
You live with someone who has Hepatitis B
You work in a healthcare setting, and you’re in daily contact with blood or bodily fluids
You’ll have no out-of-pocket costs if you meet the eligibility requirements above. If you’re not at medium or high risk for infection, you can get the vaccine covered by Medicare Part D, which is your prescription drug coverage.
Medicare and Hepatitis A vaccine
Your Medicare drug plan covers the Hepatitis A vaccine. It also covers the Hepatitis B vaccine if you’re at low risk of infection. The Inflation Reduction Act of 2022 requires these vaccines and others recommended by the CDC to be free for Medicare beneficiaries with Part D.
An estimated 3.7 million people are eligible for Medicare, but don’t have prescription drug coverage. In addition to ensuring your medications are covered, enrolling in Part D can help you prevent health conditions with important vaccines.
Does Medicare Advantage cover the Hepatitis A and Hepatitis B vaccines?
Medicare Advantage plans must cover the same services as Original Medicare (Part A and Part B). Most Medicare Advantage plans also include prescription drug coverage. These plans are sometimes called MAPD (Medicare Advantage + Prescription Drug) plans. MAPDs will cover Hepatitis A and Hepatitis B with low risk of infection, but you may have to pay a copay or coinsurance.
What other vaccines does Medicare cover?
Medicare Part B and Part D cover a number of other vaccines. Medicare Part B covers shots to prevent:
Like we mentioned, Medicare Part D covers all vaccinations recommended by the CDC. This includes:
In some cases, you may have to pay an administration fee to your pharmacy, clinic, or other vaccination site, but you can get this fully reimbursed by your drug plan. Get in touch with your plan for more information.
Medicare does not cover some vaccines if you don’t have Part D. In most cases, it won’t cover vaccinations for travel purposes either.
If you have additional questions about your Medicare plan, or need help enrolling in Medicare drug coverage, a Chapter Medicare Advisor can guide you! Call us at 855-900-2427 or schedule a time to chat to find plans that are best for your healthcare needs.