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Hepatitis B and Hepatitis C Medicare Coverage

Hepatitis B
Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic diseases. The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids. It can be prevented by vaccines that are safe, available, and effective.
Eligibility
Medicare Part B covers the hepatitis B vaccine if you are at medium or high risk for hepatitis B. Medicare considers you at medium or high risk if you:
  • Have End-Stage Renal Disease (ESRD)
  • Have hemophilia
  • Live in the same household as a hepatitis B carrier
  • Have unprotected sex with multiple partners or with someone who has hepatitis B
  • Use certain federally prohibited substances
  • Are health care professional in frequent contact with blood or other body fluids during routine work
Note: If you are at low risk for hepatitis B, the shot will be covered under Part D.

Hepatitis C

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). The virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is a major cause of liver cancer. The hepatitis C virus is a bloodborne virus and the most common modes of infection are through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, transfusion of unscreened blood and blood products, and sexual practices that lead to exposure to blood.

Eligibility
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.

Costs for both Hepa B and C Coverage
If you qualify, Original Medicare covers hepatitis B shots 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 hepatitis B shots 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 hepatitis B shot, 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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NCOV -19 and MEDICARE 2020

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Cardiovascular Disease Risk Reduction

Cardiovascular disease generally refers to conditions that can lead to a heart attack or stroke. Cardiovascular disease risk reduction visits can help detect and prevent this disease. How to know if I am Eligible? Medicare   Part B  covers an annual cardiovascular disease risk reduction visit with your primary care  provider . You do not need to show any signs or symptoms of cardiovascular disease to qualify for screening, but you must be considered competent and alert when counseling is provided.  During the screening, your provider may; Encourage aspirin use if the benefits outweigh the risks You are a man  of age 45-79 Or a woman of age 55-79 Screen for high blood pressure if you are age 18+ Provide behavioral counseling and tips to encourage a healthy diet Note: Men under 45 and women under 55 are not encouraged to use aspirin as a tool to reduce cardiovascular disease. How much will it cost? If you are eligible,  Original Medicare  will cover your cardiovascular disease risk red
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Lifetime Reserve Days

There are  90 days of  inpatient  hospital care coverage on Original Medicare for each  benefit period , In addition, you also have an additional 60 days of coverag e , called LIFETIME RESERVE DAYS .   These Lifetime Reserved Days  can be used only ONCE, and you will pay a  coinsurance  for each of it. To have a better understanding of it, let’s imagine an individual who had a 120-day  Medicare -covered inpatient stay, this means that they used 30 lifetime reserve days. After they have been out of the hospital for 60 days in a row, they will be eligible for another 90 days of hospital coverage because they will be in a new  benefit period . However, if they need  inpatient care  beyond the benefit period maximum, they will only have 30 of their 60 lifetime reserve days remaining. The above example illustrates that lifetime reserve days do not have to be applied to the same hospital stay. If you need to stay in the hospital twice for 120 days each time during different benefit
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