Which Vaccines Does Medicare Cover?Posted by Medicare Made Clear
Medicare covers most vaccines. Some are covered by Part B, and some are covered by Part D.
Getting the vaccines you need is one of the most important things you can do for your health – and for the health of those around you. Vaccines are your first line of defense against a number of infectious diseases. If you don’t get sick, then you can’t infect your loved ones, your friends or others in your community.
Vaccines covered by Medicare Part B
Medicare Part B covers three important vaccines as part of its preventive care benefits. Covered vaccines include the following:
- Flu vaccine coverage: Annual vaccine given in one shot before or during flu season, usually November through April
- Pneumonia vaccine coverage: One-time vaccine given in two shots at least one year apart
- Hepatitis B vaccine coverage: One-time vaccine given in two to four shots over one to six months for people who are medium to high risk, including people with diabetes
Part B also covers vaccines you may need if you’re exposed to a harmful virus or bacteria by accident. You might need a tetanus shot, for example, if you step on a rusty nail. Or you may need rabies shots if you’re bitten by a stray dog.
Vaccines covered by Medicare Part D
Medicare Part D covers all commercially available vaccines needed to prevent illness. You can get Part D coverage through a standalone Medicare prescription drug plan (Part D) or a Medicare Advantage plan (Part C) that includes drug coverage.
Vaccines covered by Part D include the following:
- Shingles vaccine coverage: One-time vaccine given in two shots over two to six months
- Tdap vaccine coverage (tetanus, diphtheria and pertussis/whooping cough): One shot if you’ve never been vaccinated, and a booster every ten years
- Other vaccines covered: Vaccines that are “reasonable and necessary” to prevent illness and are not covered by Part B
Part D also covers vaccines you may need if you are traveling internationally. Talk with your doctor about your travel plans and ask what vaccines are recommended.
Do I have to pay for vaccines with Medicare?
You pay nothing for vaccines covered by Part B – flu, pneumonia and Hep B – as long as your provider accepts Medicare.
Your cost for vaccines covered by Part D will depend on your specific plan. You may pay a copay or coinsurance.
The location where you get vaccinated may also affect your cost. For example, your cost may be lower if you get a vaccine at a pharmacy versus in a doctor’s office.
Where Can I Get Vaccines I Need?
You can get most vaccines at a pharmacy, doctor’s office, clinic or community health center. Talk with your doctor about what vaccines you may need. Your doctor or Part D plan provider can also help you understand whether your cost will be affected by where you go to get the vaccines that your doctor recommends.
For more information about Medicare, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.