What Vaccines Are Covered by Medicare? - AARP

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Medicare Part B covers many vaccines as free preventive benefits, but it doesn't cover all vaccines.

Likewise, Medicare Part D covers some common shots. But thanks to a new law, you won't have to pay copayments or deductibles for recommended vaccines that either part of Medicare covers.

Which vaccines does Medicare Part B cover?

Medicare Part B pays in part for doctor services and outpatient care. It also covers several vaccines as a free benefit, meaning without having to pay deductibles or copayments. The Affordable Care Act eliminated cost sharing on many types of screenings, vaccines and preventive care programs starting in 2011.

Here's a list of vaccines Part B covers. You may need to meet certain criteria based on age, risk and the time frame in which you receive the vaccine or a series of vaccines. 

COVID-19. Medicare continues to cover COVID-19 vaccines, even though the public health emergency ended May 11, 2023. Providers who participate in Medicare can't charge beneficiaries for the vaccine.  

Flu. Considered an annual vaccination, most people of all ages receive flu shots around flu season, which typically runs October through May with peak activity from December to February. The Centers for Disease Control and Prevention (CDC) recommends that adults 65 and older get the high-dose version for extra protection. 

Hepatitis B. Part B covers the hepatitis B vaccine as a preventive benefit if you're at medium or high risk for the virus, such as people with diabetes, end-stage renal disease or hemophilia. 

Pneumonia. Medicare covers the pneumonia vaccine to help protect you against pneumococcal disease, which can cause pneumonia, meningitis and other infections. Medicare covers either the single-dose vaccine or a two-dose series with the second dose required at least one year later for most people age 65 and older. People who are immunocompromised may receive the second dose sooner.  

You can use your online Medicare account to help keep track of the Medicare-covered screenings and vaccines you're eligible for in Part B.  

What vaccines doesn't Medicare Part B cover?

Part B won't cover all vaccines. But Medicare Part D, the prescription drug coverage you can purchase from private companies that Medicare regulates, will cover many more.

Starting in 2023, the Inflation Reduction Act eliminated all out-of-pocket costs for vaccines that the CDC's Advisory Committee on Immunization Practices recommends for adults. In the past, you were probably charged a copayment for vaccines billed to your Part D insurer instead of Part B.

The following vaccines are free to people enrolled in a Part D plan or Medicare Advantage plan with prescription coverage:

Hepatitis A. The CDC recommends a hepatitis A shot for children age 12 to 23 months and children age 2 to 18 who weren't vaccinated earlier. It also recommends the hepatitis A vaccine for adults at increased risk for hepatitis A, including people with chronic liver disease or those who have HIV or work in areas with a risk of infection as well as others at high risk. 

Hepatitis B. Part D covers this shot for those at low risk for hepatitis B.  

RSV. Respiratory syncytial virus (RSV) can lead to pneumonia or bronchiolitis and can worsen other chronic conditions common among older adults, such as asthma and chronic obstructive pulmonary disease (COPD). The FDA recently approved the RSV vaccine for adults 60 and older to help protect against contracting the virus.  

Shingles. The CDC recommends that everyone age 50 or older get the shingles vaccine. It now recommends two doses of Shingrix for adults 50 and older spaced two to six months apart, even if you previously received Zostavax. In 2020, Shingrix replaced Zostavax, which is no longer available in the U.S.

Tdap. This shot protects against tetanus, diphtheria and whooping cough, also known as pertussis. The CDC recommends getting a Tdap or Td booster every 10 years. 

Unless a vaccine is covered via Part B, Part D plans' formularies usually cover all commercially available inoculations to prevent illness. Even some less-common shots — including those you may need for travel to Africa, Asia, Central and South America, and the Pacific Islands — are usually covered through Part D without deductibles or copayments if the CDC recommends them for your travel.

Keep in mind

Medicare Advantage plans have some restrictions but also must cover the same Part B preventive services without any cost to you if you use an in-network provider. You may be charged if you use an out-of-network provider.

If your Medicare Advantage plan includes drug coverage, it must also cover the Part D vaccines the CDC recommends without cost sharing.

Published August 10, 2023

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