Can I Get Vaccines Covered by Medicare? – Frequently Asked Questions
This article was updated on: 10/28/2018
According to the U.S. Department of Health and Human Services, a vaccine prepares your body to fight a disease by giving you a very small amount of a weak or dead germ that causes the disease. Vaccines are especially important for older adults since your immune system weakens with age. Medicare covers vaccines through Part B (medical insurance) and Part D (prescription drug coverage).
What vaccines do Medicare Part B cover?
Flu vaccines: The influenza virus causes seasonal flu epidemics each year. The flu results in a cough, sore throat, body aches, and other uncomfortable symptoms. Medicare Part B generally covers one flu shot per flu season. You usually pay nothing for this vaccine if your provider accepts Medicare assignment.
Hepatitis B vaccine: The hepatitis B virus causes a serious liver infection according to the Mayo Clinic. Medicare Part B may cover a hepatitis B vaccine if you are at high to medium risk of contracting hepatitis B. You may be at higher risk of contracting hepatitis B if you have end-stage renal disease or diabetes. If you are determined to be at high or medium risk, you generally pay nothing for the hepatitis B vaccine. However if you are at low risk and want the vaccine anyway, you may not be covered.
Pneumococcal vaccine: The pneumococcal vaccine helps prevent certain types of pneumonia. Pneumonia can be a life-threatening condition that fills the air sacs in your lungs with fluid, according to the Mayo Clinic. The pneumococcal vaccine may be given as two shots a year apart and Medicare may cover both. Your doctor will be able to tell you if you need one or both shots. You generally pay nothing for pneumococcal shots if your health provider accepts assignment. Learn more about Medicare coverage of the pneumonia vaccine.
What vaccines do Medicare Part D cover?
Medicare Part D is optional prescription drug coverage through a private insurance company. You can get prescription drug coverage through a stand-alone Prescription Drug Plan or a Medicare Advantage plan with prescription drug coverage. Generally Part D covers all commercially available vaccines needed to prevent illness.
Tdap vaccine: Tdap is the adolescent and adult booster shot for tetanus, diphtheria, and pertussis (also called whooping cough). The Tdap vaccine is generally covered under Medicare Part D plans. Learn more about Medicare coverage of the Tdap vaccine.
Shingles vaccine: Shingles is caused by the same virus that causes chicken pox according to the Mayo Clinic. Shingles causes a painful rash that can occur anywhere on the body. The shingles vaccine can reduce the risk of shingles by 51% according to the Centers for Disease Control and Prevention. The shingles vaccine is generally covered by Medicare Part D. Learn more about Medicare coverage of the shingles vaccine.
Do you have more questions about Medicare coverage of vaccines?
You can read more about Medicare Part D coverage of vaccines here. I’d also be happy to help you. I can walk you through your options or email you information; you can request that using the links below. Or take a look at plans by clicking the Compare Plans buttons on this page.
Medicare has neither reviewed nor endorsed this information.