Does Medicare Cover Zostavax

Victoria Burke by Victoria Burke | Licensed since 2011
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This article was updated on: 10/21/2018

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Shingles is a common viral infection that causes a painful rash, according to the Mayo Clinic. The Centers for Disease Control and Prevention (CDC) reports that 1 out of every 3 people in the United States will develop shingles (herpes zoster) in their lifetime. The risk of shingles increase with age, with about half of all cases occurring in adults age 60 years old and older.

Zostavax is the brand name of a vaccine used to prevent shingles in adults ages 50 and older, according to the U.S. Food and Drug Administration (FDA). However, the CDC does not recommend the Zostavax vaccine until you are age 60 or older, when the risk of shingles and complications are the highest, according to the Mayo Clinic. The National Institutes of Health (NIH) states that this single-dose vaccine is generally given only once and usually provides lifetime protection against the shingles virus.

Does Medicare Part A and Part B cover the Zostavax shot?

With Original Medicare (Part A and Part B), care you receive in the hospital is covered under Part A, while medical care, including many preventive services and vaccines, is covered under Part B. Medicare Part B generally covers vaccines such as the flu vaccine and the Hepatitis B vaccine. However, the Zostavax shot is not included under Medicare Part B.

Does Medicare Part D cover the Zostavax shot?

If you have a stand-alone Medicare Part D Prescription Drug Plan, you have coverage for most commercially available vaccines, including the Zostavax shot. You can sign up for a Medicare Prescription Drug Plan to supplement your Original Medicare coverage during certain times of the year.

If you have a Medicare Advantage plan that includes prescription drug coverage, it also will generally cover the Zostavax vaccine. The Medicare Advantage (Medicare Part C) program offers you an alternative way to get your Medicare Part A and Part B benefits (hospice care is still covered directly under Medicare Part A instead of through the plan). Many Medicare Advantage plans also cover other services such as routine dental, vision, and hearing care. Such plans may be a convenient option for beneficiaries looking for a convenient all-in-one Medicare plan.

Would you like to learn more about the Zostavax shot and other preventive services under Medicare?

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