Does Medicare Cover Flu Shots?

Influenza, better known as the flu, is a virus that causes fever as well as other symptoms. It causes many people each year to become seriously ill. And typically takes the lives of between 25,000 – 60,000 Americans each year.

Flu season usually runs between the months of November to April. Getting a flu shot (the flu vaccine) before or at the start of flu season is an effective way to protect yourself against the flu.

So a common question many people have is, “Does Medicare cover Flu Shots?” In this article, we answer that question in clear, plain English. You will also find the average costs of flu shots and other helpful info.

The short answer is yes; Medicare will cover the cost of flu shots. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your flu shot. Below we look at what these are so you know what to expect.

Original Medicare (Medicare Part A and Part B) provides coverage for flu shots. Medicare beneficiaries are eligible for one flu shot every year.

The shot is free. There is no coinsurance or copayment. Plus, the cost will not apply to your deductible.

Coverage for flu shots falls under Medicare Part B.

There are situations where a doctor may recommend additional flu shots for some patients. In these cases, if your doctor says you need it, then Medicare will pay for the additional flu shots.

For example, if you receive a single shot of flu vaccine in January, Medicare may also provide coverage for another shot in October of the same year.

One important thing to know about flu shot coverage, however. You have to go to a Medicare approved provider. If you don’t Medicare may not pay for the flu shot.

Medicare Advantage (Part C) plans also cover flu shots. They cover everything Original Medicare covers, as well as some offer additional benefits. All Medicare Part C plans must fully cover flu shots when you see an in-network provider. And, of course, you meet the requirements that Medicare needs to cover your flu shots.

How Much Does Flu Vaccines Cost?

The CDC private sector cost for a quadrivalent flu shot may cost somewhere between $17 to nearly $26. However, the overall cost may be higher than that depending on the location. The average cost of a high-dose flu shot is about $70.

Side Effects Of A Flu Shot

Many vaccines and medications have side effects, and the flu vaccine is not an exception. Here are some of the side effects of flu shots:

Pain, redness, and swelling at the injection site
Muscle aches
Headaches
Fever (most of the time it is only low-grade)
Upset stomach

Despite these side effects, a flu shot is still one of the best ways to prevent flu. Other preventive measures are the ones we’ve all learned so well due to COVID. Mainly washing your hands, wearing a mask and social distancing. These are the main reason why flu numbers were so low during the pandemic.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.