Trevor James
Medicare covers the cost of most vaccines, with some covered by Part B and others by Part D. Part D covers all commercially available vaccines needed to prevent illness, including the shingles vaccine. Part D plans must include most commercially available vaccines on their formularies. If you have Part D coverage, you won't pay anything for vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). However, the amount you pay for other vaccines covered by Part D depends on your specific plan and provider. Medicare Part B covers four important vaccines as part of its preventive care benefits: the flu vaccine, COVID-19 vaccine, pneumonia vaccine, and hepatitis B vaccine.
| Characteristics | Values |
|---|---|
| Vaccines Covered by Medicare Part D | All commercially available vaccines needed to prevent illness. This includes the shingles vaccine and the Tdap vaccine (tetanus, diphtheria, and pertussis/whooping cough). Part D also covers vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) unless they are covered by Part B. |
| Cost | In most cases, you will not pay anything for vaccines covered by Part D if they are recommended by the ACIP. The cost for other vaccines covered by Part D will depend on your specific plan and provider, as well as the location where you receive the vaccination. |
| Exceptions | Flu, pneumonia, hepatitis B, and COVID-19 vaccinations are covered by Part B. |
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What You'll Learn
Shingles vaccine
Medicare Part D covers all commercially available vaccines needed to prevent illness. This includes the shingles vaccine, which is recommended for healthy adults over 50 and is administered in two doses, two to six months apart. The shingles vaccine is also recommended for some adults aged 19 and over who have compromised immune systems.
Original Medicare (Part A and Part B) does not cover the shingles vaccine. Part B covers outpatient care and preventive vaccines like those for the flu, pneumonia, hepatitis B, and COVID-19. However, if you have a Medicare Part D plan, either as standalone coverage or as part of a Medicare Advantage plan (Part C), your shingles vaccine will be covered.
Part D plans must include most commercially available vaccines on their list of covered drugs (formulary). This includes all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), such as the shingles vaccine. Your Part D plan will not charge you a copayment or apply a deductible for any ACIP-recommended vaccines.
The location where you get vaccinated may affect your cost. For example, your costs may be lower if you get the vaccine at a pharmacy instead of a doctor's office. You can get the shingles vaccine at most pharmacies, but you may need a doctor's prescription.
If you don't have vaccine coverage through Medicare or another insurance plan, you can contact the manufacturer of Shingrix. They offer an assistance program to help eligible people afford this and other vaccines.
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Tdap vaccine
Medicare Part D covers all commercially available vaccines needed to prevent illnesses. This includes the Tdap vaccine, which protects against tetanus, diphtheria, and pertussis (whooping cough).
The Tdap vaccine is recommended for adults who have never been vaccinated and requires a booster every ten years. It is covered by Medicare Part D, and those with this plan will pay nothing out of pocket for the Tdap shot. This is because Medicare Part D covers all adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), which includes the Tdap vaccine.
Medicare Part D can be obtained as a stand-alone prescription drug plan or as part of a Medicare Advantage plan (Part C) that includes drug coverage. It is offered by private companies and covers most commercially available vaccines on their formularies.
It is important to note that the location where one receives the vaccination may affect the cost. For example, costs may be lower at a pharmacy than at a doctor's office. It is recommended to speak with a doctor or Part D plan provider to understand whether the cost will be affected by the location of the vaccination.
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Vaccines recommended by the Advisory Committee on Immunization Practices (ACIP)
Medicare Part D covers all commercially available vaccines needed to prevent illness. If you have Part D coverage, you won't have to pay for any vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). The Advisory Committee on Immunization Practices (ACIP) develops recommendations on how to use vaccines and passive immunizations to control diseases in the United States. These recommendations become official CDC policy once they are adopted by the CDC Director.
- JYNNEOS (Smallpox and Mpox Vaccine, Live, Nonreplicating) for persons aged 18 years and older who are at risk for mpox during an outbreak.
- Bexsero MenB-4C Vaccine: Updated Recommendations for a new dosing interval and schedule.
- Measles, Mumps, Rubella Vaccine (PRIORIX): Recommended for use in the United States in 2022.
- Bivalent COVID-19 Vaccine: Recommended for adults 18 years and older and children aged 6 months to 5 years.
- 15-Valent Pneumococcal Conjugate Vaccine: Recommended for use in U.S. children.
- Seasonal Influenza Vaccine: Recommended for routine annual vaccination for all persons aged 6 months and older who do not have contraindications for the 2025-2026 season.
- Novavax COVID-19 Vaccine: Recommended for adults 18 years and older.
- Moderna and Pfizer-BioNTech COVID-19 Vaccines: Recommended for children aged 6 months to 5 years.
- MenABCWY vaccine: Recommended for healthy persons aged 16-23 years and persons aged 10 years and older who are at increased risk of contracting meningococcal disease.
- GSK's MenABCWY vaccine: May be used when both MenACWY and MenB are indicated at the same visit.
- Rabies Vaccine: Recommended use of a modified pre-exposure prophylaxis vaccination schedule to prevent human rabies.
- Ebola Vaccine: Recommended for two additional populations in 2021.
- Chikungunya Vaccine: Recommended for persons aged 18 years and older traveling to areas with evidence of the chikungunya virus.
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Vaccines needed for international travel
Vaccines are an important way to protect yourself and others from infectious diseases. Medicare Part D covers all commercially available vaccines needed to prevent illness. This includes vaccines you may need for international travel. However, it's important to note that not all vaccines are covered by Medicare Part D, and the amount you pay for vaccines under Part D will depend on your specific plan and provider.
When it comes to international travel, it is crucial to plan ahead and ensure you have the necessary vaccines and medicines to stay healthy during your trip. The specific vaccines you need will depend on your destination and the health risks present there. It is recommended to make an appointment with your healthcare provider or a travel health specialist 4-6 weeks before your trip to get destination-specific advice and recommendations. They can provide you with information on vaccines, medicines, and other health precautions specific to your travel plans.
Some vaccines that may be recommended or required for international travel include the yellow fever vaccine and medicines to prevent malaria. It is important to note that some countries require proof of vaccination for entry, so it is essential to check the requirements for your intended destination.
In addition to the vaccines covered by Medicare Part D for international travel, Medicare Part B covers vaccines for flu, pneumonia, hepatitis B, and COVID-19. These vaccines are considered preventive care benefits and are typically covered without any cost-sharing.
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Vaccines to prevent illness
Vaccines are essential to preventing serious infectious diseases and protecting your health and the health of those around you. Medicare covers the cost of most vaccines, with some covered by Part B and some by Part D.
Medicare Part D covers all commercially available vaccines needed to prevent illness. This includes the shingles vaccine, which is recommended by the Advisory Committee on Immunization Practices (ACIP). Part D plans must include most commercially available vaccines on their formularies. Part D may also cover vaccines you need for international travel. The Tdap vaccine (tetanus, diphtheria, and pertussis/whooping cough) is also covered by Part D.
Medicare Part B covers four important vaccines as part of its preventive care benefits. These include the flu vaccine, the COVID-19 vaccine, the pneumonia vaccine, and the hepatitis B vaccine.
As of January 2023, all Medicare-covered vaccines should be free, with no cost-sharing. This means you should not owe any copayments, coinsurance, or deductibles. However, the location where you get vaccinated may affect your cost. For example, your costs may be lower if you get a vaccine at a pharmacy instead of a doctor's office.
It is important to discuss your vaccination needs with your healthcare provider, as their recommendations may vary depending on your health status and medical conditions.
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Frequently asked questions
Medicare Part D covers all commercially available vaccines needed to prevent illness. This includes the shingles vaccine and the Tdap vaccine (tetanus, diphtheria, and pertussis/whooping cough). Part D also covers vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) and vaccines needed for international travel.
The amount you pay for vaccines covered by Part D depends on your specific plan and provider. In most cases, you won't pay anything for vaccines recommended by the ACIP as long as your provider accepts Medicare. The location where you get vaccinated may also affect your cost, with pharmacies typically offering lower costs than a doctor's office.
Discuss your vaccination needs with your healthcare provider. Their recommendations may vary depending on your health status and medical conditions. Your doctor can help you understand whether your costs will be affected by where you go to get vaccinated. You can receive vaccinations at a pharmacy, doctor's office, clinic, or community health center.
