Medicare's Other Vaccines

In a world dominated by COVID-19 headlines, it can be difficult to remember there are other illnesses that can make us sick. Everything we had before is still around, it just does not make the news. So, how does Medicare cover vaccines and immunizations?

Both Medicare Part B and Part D cover vaccines and immunizations. Medicare Part B covers one influenza (flu) shot per flu season. Typically, the flu season is considered to be November through April. Original Medicare and most Medicare Advantage Plans cover the flu shot at 100%, so Medicare beneficiaries have no out-of-pocket costs. The flu shot helps protect from the influenza virus, and it is recommended seniors get one every year.

Medicare Part B covers two pneumonia shots. The pneumonia shot helps protect against pneumonia, which is an infection and inflammation of the lungs. I have had pneumonia and do not want that again. Medicare will cover the first shot given at any time and the second shot if it is given at least one year after the first shot. Medicare Part B pays 100% of the Medicare-approved amount of this vaccine, so there is no out-of-pocket costs for most Medicare beneficiaries.

Part B also covers vaccines you need if you are exposed to a virus or bacteria in an accident, such as a tetanus shot if you step on a rusty nail or rabies shots if you are bitten by a stray animal.

Hepatitis B vaccines are also covered by Medicare Part B for those considered at medium to high risk of infection. Hepatitis B causes inflammation and damage to the liver. Under Part B, there is no cost to the Medicare beneficiary. If a person is considered low-risk for Hepatitis B, then Medicare Part D covers the vaccine, and the cost can vary depending on the prescription drug plan.

Medicare Part D, the prescription drug portion of Medicare, covers most other vaccines, including the shingles shot and the Tdap. It also covers other vaccines that are medically necessary. The cost of vaccines varies depending on which vaccine is required, which plan you have and where you have the vaccine. Check with your plan on where you can get the best coverage on needed vaccines — most offer the best coverage at an in-network pharmacy. Medicare Advantage Plans also cover the Part B vaccines and the Part D vaccines. You would need to check with your plan to determine the cost and location that works best for each plan.

As the world goes COVID-19 crazy again, remember there are still other illnesses out there that we need to protect against, and Medicare covers a variety of vaccines. Take care of yourself, and stay safe and healthy.

If you have Medicare questions, please call Aging Matters at 1 (800) 392-8771. Because Aging Matters.