Medicare covers many vaccines and immunizations – often at no or little cost to you. Understanding your coverage is important, as certain vaccines are only covered by either medical coverage (Medicare Part B or plans provided through a private insurer) or prescription drug coverage (Part D).

Let’s take a look at the differences between Part B and Part D coverage, what vaccines are typically covered by each, and what you need to know about vaccine eligibility.

Are you a HealthPartners Medicare member who wants more information on vaccine coverage? Call the number on the back of your member ID card to contact your plan’s Member Services team.

Medicare vaccine coverage through Part B

If you have Original Medicare Parts A and B, or a Medicare plan from a private insurance company, your Part B medical coverage usually takes care of the most common immunizations. Private Medicare health plans also cover additional vaccines through their Part D benefit.

You might wonder why vaccines are covered in two different ways. It’s because Medicare Part D wasn’t available until 2006. Before that, Part B provided Medicare vaccine coverage, and it covers the same vaccines today.

Vaccines covered under medical coverage

In some cases, your Part B medical coverage will cover certain vaccines if you’re at risk of getting a related disease or illness. If you have Original Medicare, it’s easy to check if your vaccine is covered.

Some of the most common vaccines that Medicare Part B covers includes:

(Note: While the hepatitis B vaccine is sometimes covered under Medicare Part B, the hepatitis A vaccine is covered under Medicare Part D.)

Vaccine coverage through Medicare Part D

The Inflation Reduction Act of 2022 made important changes to coverage of vaccines under Medicare Part D. Now Medicare beneficiaries don’t have to pay a deductible or any out-of-pocket costs for vaccines that the Centers for Disease Control and Prevention (CDC) recommends for adults. This new law helps make crucial vaccines cheaper and more accessible.

Shingles vaccine coverage

The risk of getting shingles increases as you age. Fortunately, the Shingrix vaccine for shingles is covered under Medicare Part D. If you have Part D coverage, you’ll be able to get the Shingrix vaccine for a $0 copay.

Check with your insurance company to confirm vaccine coverage:

If your doctor recommends you get a vaccine, check with your insurance company. They can let you know whether the vaccine:

  • Is covered
  • Is covered under your medical coverage or prescription drug coverage
  • Is affordable for you. Your insurance may not cover the entire cost if you don’t have Part D coverage or if the vaccine isn’t recommended by the CDC

Medicare Part D now covers the RSV vaccine

As mentioned before, Medicare Part D now fully covers vaccines recommended by the CDC for adults over 65, including the RSV vaccine. Since the Advisory Committee on Immunization Practices (ACIP) recommends it for adults 60 and older, Medicare Part D will cover your costs as long as you have Medicare Part D coverage.

Does Medicare cover travel vaccines?

Medicare doesn’t cover travel-specific vaccines such as typhoid or yellow fever shots due to factors that require care to be considered “reasonable” or “medically necessary.” If you’re looking for extra protection before a big trip, you can still get these vaccines, but you’ll most likely pay out of pocket.

Is the COVID-19 vaccine covered by Medicare?

Medicare Part B covers the COVID-19 vaccine at no charge to you. This includes any deductibles, copayments or administration fees by your provider. The CARES Act made this the law as of March 2020.

The COVID-19 vaccine is also covered by Medicare Advantage or Cost plans. At a minimum, these plans are required to cover everything Original Medicare does, and many cover more services.

Knowing how your vaccines are covered can help you estimate how much you’ll be responsible for paying, which makes it easier to budget your health care costs. And remember, you can always call your Member Services team with any questions.