Does Medicare Cover the Shingles Vaccine?
If you want to get your shingles vaccine, you’ll need to have a Part D plan with Original Medicare or Medicare Advantage
Reviewed by: Stephanie Demus, Licensed Insurance Agent. Written by: Aaron Garcia.
Whether you choose to add a Part D plan to your Original Medicare Parts A and B or enroll in a Medicare Advantage plan that includes Part D, you need the prescription drug plan to cover your shingles vaccine
The cost of your shingles vaccine will depend on your Part D plan, but in most cases, you’ll have a copay when you receive the vaccine
Medicare Part D covers both the two-shot and single-shot shingles vaccines
Technically, Original Medicare will not cover your shingles vaccination. How does Medicare cover the shingles vaccination? If you have a Medicare Part D prescription drug plan, immunizations and vaccinations that help prevent illness are a part of that plan. Part D is a separate plan from Part A and Part B, which means you must enroll in (and pay for) it separately if you have Original Medicare. Most Medicare Advantage plans include Part D coverage.
The price for a standard shingles vaccine, Shingrix, is roughly $150 to $190. If You have Medicare Part D included with either Original Medicare or Medicare Advantage, you may pay less.
How much does a shingles shot cost with Medicare?
The cost of your shingles shot if you have Medicare coverage largely depends on your plan. How does Medicare cover the shingles vaccine for seniors? If you have Medicare Part D coverage, you’ll pay a copayment to the pharmacy or provider that gives you your shot. This happens if you’ve already met your deductible for the year. Remember, if you have Medicare Advantage, you may have Part D included. If so, you’ll also pay a copay.
Does Medicare cover the new 2 part shingles vaccine?
Medicare Part D covers Shingrix, a two-shot vaccine for shingles. Medicare also covers a single-shot vaccine option, called Zostavax.
Medicare Part D still covers shingles vaccines in 2021, but it’s important to double-check your coverage options each year to ensure your needs are covered. Medicare Part D coverage and pricing can change from year to year.
How does Medicare Part D cover the shingles vaccine?
Medicare Part D can cover vaccines and prescription drugs. Your vaccine and its cost are on a list in your plan’s drug formulary, alongside other prescription drug costs. Your vaccine cost counts toward your deductible like other Part D services. You may have to pay the full price for your shingles vaccine if you have not met your annual deductible.
Does Medicare cover shingles shots at pharmacies?
Always check with your insurance company, but getting your shingles shot at a doctor’s office may not be covered the same as if you get it at a pharmacy. Because it’s a Part D service, shots given at pharmacies are applied directly to your Part D plan — just like other prescription drug costs. Does Medicare pay for shingles shot if a doctor gives it? Probably, but you may need to pay upfront and submit a claim for reimbursement.