Does Medicare Cover Antivenom?

Venomous snake bites are dangerous and can be deadly. Snakes, like vipers and rattlesnakes, have very potent venom. For some species it may only take a single bite to potentially kill a person.

The best chance to recover from a snakebite is through the use of antivenom.

If you or a family member were ever in the unfortunate situation to be bitten by a venomous snake, you may be wondering, “does Medicare cover antivenom?” In this article, we answer that question in clear, plain English. You will also find the average costs of antivenom if you pay for it out of pocket.

The short answer is it seems like the answer is yes. If you seek emergency treatment for a snakebite, Medicare will cover the cost of your antivenom treatment. That said, this is not a common treatment and Medicare doesn’t seem to have any clear information about coverage for antivenom. So below we’ll take a closer look at this topic. It will give you a better idea of what to expect when it comes to Medicare and antivenom.

Original Medicare

Original Medicare (Medicare Part A and Part B) may provide coverage for antivenom. As of now, there is no sufficient data on whether Original Medicare provides coverage for antivenom or not.

But it is likely that in most cases, Medicare will provide coverage for snake antivenom. Upon getting bit by a snake, it is most likely that you will be rushed to the emergency room should you call for treatment.

Should you be admitted to the hospital after your snake bite treatment, it is possible that Medicare Part A may provide coverage for the costs of services. Including antivenom necessary to save your life.

On the other hand, should you be immediately discharged after getting treatment for your snake bite, it is likely that coverage will fall under Medicare Part B.

It is also possible that Medicare Part D will provide coverage for the antivenom vials themselves. So if you live in an area where you may be exposed to venomous snakes, having a Medicare Part D plan may be even more important for you. At the same time Medicare Part B will provide coverage for the administration of the antivenom itself.

If Medicare Part B provides coverage they will cover 80 percent of the costs of snake bite treatment. You will pay for the remaining 20 percent.

Part C Coverage for Antivenom

What if you have a Medicare Advantage plan? In that case coverage for any treatment you get will be the same as it is for Original Medicare. So if Original Medicare will pay for antivenom, then Medicare Advantage will too.

How Much Does Snake Antivenom Cost?

Snake antivenom is super expensive in the U.S. If you get CroFab, the most common type of antivenom available, at a pharmacy, it usually costs around $3,000 if you pay out of pocket.

There are reports of antivenom costing around $20,000 or more if it’s administered in a hospital. And oftentimes multiple doses are necessary so total treatment costs just for antivenom can reach around $100,000.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.