Does Medicare Cover Hepatitis B Vaccination?
Medicare covers the cost of hepatitis B vaccinations if you are at medium or high risk for the hepatitis B virus. Your risk depends on certain medical or lifestyle conditions. Starting on January 1, 2023, those with Medicare perscription drug coverage can get the hepatitis B vaccine with no deductible or cost-sharing. Your doctor can determine if you are at medium to high risk and eligible for Medicare coverage for a hepatitis B vaccination.
- Written by Terry Turner
Senior Financial Writer and Financial Wellness Facilitator
Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).Read More
- Edited ByMatt Mauney
Matt Mauney is an award-winning journalist, editor, writer and content strategist with more than 15 years of professional experience working for nationally recognized newspapers and digital brands. He has contributed content for ChicagoTribune.com, LATimes.com, The Hill and the American Cancer Society, and he was part of the Orlando Sentinel digital staff that was named a Pulitzer Prize finalist in 2017.Read More
- Reviewed ByAflak Chowdhury
Aflak Chowdhury is a Medicare expert and independent insurance broker specializing in group health insurance. He has worked for major providers including Humana and Principal Financial Group and today works mainly in the small group market.Read More
- Published: March 26, 2021
- Updated: March 2, 2023
- 5 min read time
- This page features 9 Cited Research Articles
- Edited By
When Will Medicare Cover a Hepatitis B Vaccination?
Hepatitis B vaccinations are considered a preventive service covered by Medicare Part B medical insurance.
To qualify, you must be enrolled in Medicare and meet Medicare’s definition of medium or high risk for the virus. Your doctor makes the determination of your eligibility based on a list of medical conditions and other factors that increase your risk.
As for costs, the Inflation Reduction Act will make your hepatitis B and A vaccine free for people with Medicare prescription drug coverage in 2023. This new vaccine coverage determined that Part D-covered adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) will no longer have a deductible or cost-sharing. Hepatitis B is on ACIP’s list of vaccine reccomendations and guidelines.
- End-stage renal disease (ESRD)
- You are a health care worker and have frequent contact with blood or other body fluids
- You live with someone who has hepatitis B
If your doctor determines you are at medium or high risk, you will pay nothing for the hepatitis B shot so long as your doctor or other qualified health care provider giving you the vaccination accepts Medicare.
Medicare Advantage plans will also pay for your shot since these private plans are required to cover everything Medicare Part A and Part B cover.
What Is Hepatitis B?
Hepatitis B is the most common serious liver condition in the world, according to the Hepatitis B Foundation. It is caused by the hepatitis B virus which is transmitted through blood or other bodily fluids.
Though it’s preventable and treatable, as many as a million people globally die every year from hepatitis B. You may have the infection — even a chronic case — and still show no signs of infection.
Left untreated, it can develop into a serious liver condition such as cirrhosis or liver cancer.
- Hepatitis A
- Found in infected people’s feces and can be spread by close contact or through contaminated food and water. Hepatitis A does not result in a chronic infection, but you will remain sick for several weeks. Recovery is usually complete and once you have it, you cannot get it again. There is no medication to treat hepatitis A.
- Hepatitis B
- Spread when blood or bodily fluids from an infected person enters the body of someone who’s not infected. Hepatitis B can be spread through sex, shared needles, accidental exposure on the job or can be transmitted from mother to baby at birth. It can cause serious liver damage, disease or cancer. There is no medication to treat hepatitis B.
- Hepatitis C
- Spread when blood or bodily fluids pass from an infected to uninfected person through the same methods as hepatitis B. Kills about 20,000 people in the U.S. each year. It can also result in serious liver disease and cancer. Hepatitis C is the leading cause for liver transplants in the U.S. There is no vaccine, but there is medication to treat hepatitis C if it is diagnosed quickly.
What to Expect from a Hepatitis B Vaccination
The hepatitis B vaccine is considered one of the safest vaccinations available — with more than 1 billion hepatitis B vaccinations given since the first one was introduced. It’s also considered the first anti-cancer vaccine since it can prevent liver cancer caused by the hepatitis B virus.
There are multiple brands of hepatitis B vaccines. These are typically delivered in a three-dose schedule, but a recent version of the vaccine is delivered in just two shots.
- First Shot
- You can receive it at any time.
- Second Shot
- You should wait at least 28 days after your first shot.
- Third Shot
- You should wait at least 16 weeks after your first shot and at least eight weeks after your second shot.
In 2017, the U.S. Food and Drug Administration approved a new hepatitis B vaccine for adults 18 and older which requires only two shots. The brand name is Heplisav-B and the two doses are given one month apart.
Does Medicare Cover Other Types of Hepatitis Vaccinations?
There are five different types of hepatitis (A through E). There are vaccinations available only for hepatitis A and hepatitis B.
Starting on January 1, 2023, Medicare will cover hepatitis B and hepatitis A vaccinations since they are on ACIP’s list of vaccine reccomendations and guidelines. You have to have Medicare perscription drug coverage to access this benefit. This means you can be enrolled in either Part D or Medicare Advantage.
Hepatitis B and C are the most common types of hepatitis. There is no vaccination against hepatitis C, but Medicare does cover screening for hepatitis C.
9 Cited Research Articles
- U.S. Centers for Disease Control and Prevention. (2022, October 5). Reduced Drug Prices, Enhanced Medicare Benefits Under the Inflation Reduction Act Frequently Asked Questions (FAQs). Retrieved from https://www.cms.gov/files/document/10522-external-faqs-about-inflation-reduction-act.pdf
- U.S. Centers for Disease Control and Prevention. (2020, July 28). Hepatitis A VIS. Retrieved from https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-a.html
- U.S. Centers for Disease Control and Prevention. (2020, July 28). Hepatitis C. Retrieved from https://www.cdc.gov/hepatitis/hcv/index.htm
- Immunization Action Coalition/ (2020, May). Hepatitis A, B, and C: Learn the Differences. Retrieved from https://www.immunize.org/catg.d/p4075.pdf
- U.S. Centers for Disease Control and Prevention. (2015, July 9). Hepatitis B Vaccination. Retrieved from https://www.cdc.gov/vaccines/pubs/pinkbook/hepb.html
- Hepatitis B Foundation. (n.d.). Vaccine for Hepatitis B. Retrieved from https://www.hepb.org/prevention-and-diagnosis/vaccination/
- Hepatitis B Foundation. (n.d.). What Is Hepatitis B? Retrieved from https://www.hepb.org/what-is-hepatitis-b/what-is-hepb/
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Hepatitis B Shots. Retrieved from https://www.medicare.gov/coverage/hepatitis-b-shots
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Hepatitis B Virus Infection Screenings. Retrieved from https://www.medicare.gov/coverage/hepatitis-b-virus-hbv-infection-screenings
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