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Does Medicare Cover HIV Treatment? Let’s Find Out!

Does Medicare cover HIV treatment

HIV is an infection that transmits through sexual contact (STI). It can also transmit during pregnancy, childbirth, or breast-feeding through contact with contaminated blood or from mother to infant. The national HIV testing day is on June 27. This year, we have seen a rise in HIV patients. There are currently around 1.1 million individuals living with the Human Immunodeficiency Virus in the US (HIV). It will help improve the health and lives of people living with HIV to receive medical care, support, and sustain healthy behaviors. For HIV prevention, you must go through the screening process to be sure of your result. So, Does Medicare cover HIV treatment? Let’s find it out!

Does Medicare Cover HIV Treatment?

Original Medicare, Medicare Part D, and Medicare Advantage cover HIV therapy differently.

Part A coverage

Medicare Part A covers hospitals, hospices, nursing homes, and home health care. HIV patients who need hospitalization for symptoms or therapy are covered for:

  • Inpatient hospital stays that don’t last too long.
  • Treatments and drugs required during hospitalization
  • Medical attention at a nursing home for a limited time
  • Few options for home health care
  • Hospice care for the end of life

Part B coverage

Medicare Part B includes diagnostic and outpatient care. HIV tests, medicines, and other services are covered for:

  • Appointments with primary care physicians and specialists for screening, diagnosis, and treatment
  • HIV checkups
  • HIV immunizations (when developed)
  • Diagnostic lab tests, imaging, etc.
  • Medicines are given to a patient by a doctor at an outpatient clinic
  • Assistance with mental health issues while undergoing therapy

Part C Coverage

Medicare Part C, sometimes called Medicare Advantage, replaces “original Medicare” (parts A and B). Part C must cover everything original Medicare does, including HIV treatment. Most Medicare Advantage plans cover HIV-related prescriptions.

A Medicare Advantage Special Needs Plan (SNP) can offer chronic illness patients extra advantages. All SNPs cover prescription drugs, HIV-specific specialists, and other medical items and services.

Part D Coverage

Medicare Part D covers at-home prescription medications, including HIV prevention and treatment.

Part D pricing and coverage rely on the plan’s prescription formulary, which groups drugs by kind and price. Regardless of the formulary, all Medicare prescription drug plans must cover HIV drugs.

Coverage for Medigap

Medigap supplements Medicare. These plans cover coverage costs. All Medigap policies cover Part A coinsurance, copayments, and blood transfusions. Some policies cover Part A and Part B deductibles, nursing home costs, excess charges, and emergency medical expenditures abroad.

Medigap does not cover prescription drugs. Medicare Parts C and D are for beneficiaries who require more coverage.

For HIV, NewMedicare Is Offering Its Services!

NewMedicare.com provides HIV scans; for those with Medicare who ask for tests, pregnant women, and people at higher risk of infection (such as gay and bisexual men, injection drug users, or people with multiple sexual partners). 

There have been many improvements in treatment, but early testing and diagnosis play critical roles in reducing disease transmission, extending life expectancy, improving HIV prevention, and reducing care costs.

Now is the time you can get yourself checked. To get updates and to learn more about National HIV Testing Day, visit NewMedicare.com.

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