Access to Hepatitis C treatment improves in Ohio
Medicaid will now pay for treatment for people who inject drugs
Maybe you or someone you care about has been exposed to the Hepatitis C virus (HCV). Or maybe you’ve already been diagnosed but haven’t gotten treated for HCV because you think you are not eligible for treatment, even though you have Medicaid.
If this was 2015, you would probably be right. You wouldn’t have been eligible then if didn’t have extreme liver damage or hadn’t been sober for six consecutive months. But, fortunately, Medicaid rules have changed significantly since then and, in 2021, you can likely get tested for Hepatitis C and get treatment if you have it.
That’s great news because Hepatitis C is an infection caused by a virus that attacks the liver and can cause fatigue, nausea, yellowing of the skin and even death. If left untreated, a person could need a liver transplant to survive.
Click to see Hep C rates in Ohio counties
Hepatitis C is often spread by sharing needles, meaning many people who have injected heroin, meth and other drugs have Hepatitis C, even if they haven’t been diagnosed or received treatment. This is something that can change in Ohio because the state Medicaid program has reduced many barriers to getting diagnosed and treated.
Hepatitis C is easily treatable by a medical health professional and treatment has gotten easier and less demanding in recent years. Hepatitis C used to require weekly medications, often injections, that would cause difficult side effects. But, today, chronic Hepatitis C can usually be cured completely by taking oral medications daily for two to six months.
More than 18,000 Ohio residents had Hepatitis C in 2018, according to the Ohio Department of Health. The highest rates were in southern Ohio.
Here’s what you need to know about Hepatitis C in Ohio
What are Medicaid’s Hepatitis C current rules on sobriety?
Medicaid has removed most restrictions to getting treatment for Hepatitis C.
Medicaid no longer has any sobriety requirement. None.
From Medicaid’s perspective, you can be actively using and they will pay for Hep C treatment. This new policy is consistent with the recommendations of the American Association for the Study of Liver Disease. Medicaid provider managed care plans (Molina, CareSource, Buckeye, Paramount, United Healthcare) also do not require sobriety for treatment.
Tat said, some private physicians will not agree to provide treatment unless you are sober so you may have to shop around a bit for a doctor.
What are Medicaid’s Hepatitis C current rules on liver damage before treatment is given?
Ohio Medicaid no longer requires that you have severe liver damage from the Hepatitis C virus or that you get a liver scan to qualify for treatment. Dropping the liver scan requirement, which just happened in 2021, is huge. There are only a few places in Ohio to get the scans, and it was often difficult for people to access them.
Your doctor will need to determine whether you are medically able to take the antiviral medications involved in Hepatitis C treatment. They might ask whether you have an allergy that prevents you from taking some medications or if you have a medical condition (such as certain heart and kidney problems or pregnancy). These conditions may complicate treatment, but they don’t automatically mean that you can’t get it.
Treatment plan must be developed by or in consultation with a gastroenterologist, heptologist, or infectious disease specialist. Medicaid will pay for you to see a specialist.
So, with the exception of this specialist requirement, Ohio Medicaid has removed the barriers to obtaining treatment for Hepatitis C. It is now more possible than ever for all people to get the help they need, including people who are actively using drugs or are new to recovery.
Who is eligible for Medicaid?
Sometimes rumors circulate in a community that you must be sober to qualify for Medicaid. Or that you have to have children. Or that you can’t have an arrest record. These are not true.
Eligibility for Medicaid in Ohio is pretty straightforward. There are 4 eligibility requirements:
- You must meet citizenship requirements, although people who are not US citizens may qualify for certain programs.
- You must be an Ohio resident.
- You need to have or get a Social Security number.
- You must meet financial eligibility requirements. These differ depending on your age, able-bodiedness, marital status, and parental status. However, single adults are eligible as are people with children, older people, and people with disabilities.
If you are not sure whether you qualify, check at the Ohio Medicaid website here.
Where can I get tested and treated?
If you are looking for Hepatitis C testing, check with your primary care provider, your county health department, or your local syringe service provider.
If none of those is a possibility, the Ohio Department of Health provides a list of testing sites. It is available here. An updated version of this guide is in the works. Ohio Department of Health plans to have it available by April 1.
Unfortunately, there is currently no list of providers. However, both the Ohio Department of Health and Harm Reduction Ohio are working to assemble lists, including whether the provider accepts Medicaid. The Ohio Department of Health hopes to have a preliminary list available by April 1. HRO will let you know as soon as it is available. Meanwhile, check with your primary care provider or local hospital or your case manager to see if they can help you find treatment.
Is it important to get treatment?
Yes. If you have a positive test for Hepatitis C, it is critically important to talk with a healthcare provider. Most people who develop HCV become chronically ill. Even if they have no symptoms, they are sustaining liver damage every day that they have HCV. If you have chronic HCV, your liver can become so damaged that you develop cirrhosis, liver cancer, or liver failure. Liver failure will lead to either a liver transplant or death. So, for your own health, get tested and seek treatment if you test positive.
Treatment is also important for preventing the spread of Hepatitis C. HCV is transmitted by blood exposure and a very small amount of blood can transmit the disease. These days, the most common means of transmission is the equipment used to inject drugs. But it can also be spread by sharing snorting straws, using unlicensed tattoo shops, or by sharing toothbrushes. You can transmit Hepatitis C to your child during the birth process.
How can Hepatitis C be prevented?
Hepatitis C is a blood borne disease that results from direct contact with the blood of an infected person. To avoid transmitting or contracting HCV, you should try to:
- Avoid sharing any injection equipment, including needles and syringes but also cookers.
- Avoid sharing snorting equipment, including straws.
- Get your tattoos and piercings from licensed people who are using clean needles every time.
- Use appropriate protection (such as condoms or dental dams) if you engage in sex that may involve bleeding.
- Avoid sharing personal care items that may have even very tiny amounts of blood. This includes toothbrushes, nail clippers, and razors.
If you think you may have been exposed, please get tested!
For more information, visit these web sites:
The American Association for the Study of Liver Diseases’ recommendations for testing and treatment of Hepatitis C. https://www.hcvguidelines.org/
The association’s statement on people who inject drugs especially important. https://www.hcvguidelines.org/unique-populations/pwid
The American Liver Foundation’s Hepatitis C Information Center. https://liverfoundation.org/…/diseases-of…/hepatitis-c/
The Centers for Disease Control’s page on Hepatitis C. https://www.cdc.gov/hepatitis/hcv/cfaq.htm#transmission
