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If you suspect exposure to the rabies virus, it’s critical to get immediate medical treatment. The disease transmits from animals to humans through their saliva. Rabies is most prevalent among wild animals. Yet, unvaccinated domestic dogs and cats can still catch and transmit the disease.
If you’ve been exposed to this virus, a common question you may have is, “Does Medicare cover rabies shots?”
In this article, we answer the question in clear, plain English. You will also find the average costs of Rabies Shots for those who have to pay for this treatment out of pocket.
Does Medicare Cover Rabies Shots?
The short answer is yes; Medicare will cover the cost of rabies shots. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your rabies shots. Below we look at what these are so you know what to expect.
Original Medicare Coverage of Rabies Shots
Original Medicare (Medicare Part A and Part B) provides coverage for rabies shots. This plan covers your Rabies Shots when they are medically necessary. To ensure you get coverage, you’ll need a healthcare provider to order the treatment for you.
Are Rabies Shots Covered by Medicare Part A or Part B?
Medicare Part A covers rabies shots if it takes place in an inpatient setting.
Part B covers the administration of the shots in outpatient settings.
Once approved, Medicare Part B covers 80 percent of the costs of rabies shots. You will pay for the remaining 20 percent.
Medicare Advantage Coverage of Rabies Shots
Medicare Advantage plans (Medicare Part C) also provide coverage for rabies shots. These plans must cover the same treatments and services that Original Medicare covers.
But these plans will also cover additional benefits Original Medicare does not cover. What these other benefits are and how much your out-of-pocket costs are will depend on your plan.
Medicare Part C plans that include prescription drug plans also cover medications.
Medicare Part D, which is Medicare’s prescription drug plan, also provides coverage for rabies shots.
Both Medicare Part C and Part D plans are through private insurance companies. One hundred percent of both Medicare Part C and Part D plans to provide coverage for the medication rabies shots.
More on Rabies Shots and Medicare
Rabies shots are listed as a tier 3 drug in the Medicare drug formulary. Most of the time, the Medicare drug formulary only has five tiers. Most of the time, Tier 3 medications are preferred branded medicines. Tier 3 medications are more expensive than Tier 1 and 2 medications.
Most Medicare plans also require you to have prior authorization. Once you have that, then the plans will cover your medication. The use of this medication has to be for medically necessary purposes. You must contact your plan provider to get authorization first.
How Much Do Rabies Vaccines Cost?
Rabies vaccination usually costs somewhere between $500 to $1,200. This price range includes the vaccine administration, the consultation fee, and the cost of three required doses.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. 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.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series, including: Does Medicare cover top surgery?