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Vaccines are an incredibly important healthcare development that allow us to protect ourselves and others from disease. We have developed vaccines against countless diseases from tetanus to COVID-19. It is important to stay up to date on your vaccines, so cost should not be a barrier.
So a common question many people have is, “does Medicare cover vaccines?” In this article, we answer that question in clear, plain English. You will also find the average costs of vaccines and other helpful info.
Does Medicare Cover Vaccines?
The short answer is yes; Medicare will cover the cost of administration of vaccines. 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 vaccine administration. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for vaccine administration. However, Original Medicare only provides coverage for certain preventive vaccines. Coverage for preventive vaccines is provided by Medicare Part B. Preventive vaccines that Medicare Part B covers include the following:
- Influenza (flu) shots
- Pneumonia shots
- Hepatitis B Shots
- COVID-19 vaccines
Under the CARES Act, coverage for FDA-approved COVID-19 vaccines is provided by Medicare Part B. Medicare Part B covers 100 percent of the costs of COVID-19 Vaccines. You will not pay copayment or coinsurance.
Medicare Part B also provides coverage for certain vaccines if you have been exposed to a certain virus or disease such as tetanus or rabies.
Part C and Part D Coverage for Vaccines
Medicare Advantage plans (Medicare Part C) also provide coverage for vaccines. They cover everything Original Medicare covers, as well as some additional benefits. However, coverage and your out-of-pocket costs will vary depending on the specifics of your plan.
Since many Medicare Part C plans have prescription drug coverage, they also provide coverage for some vaccines not covered by Medicare Part B. All Medicare Part C plans also provide coverage for COVID-19 vaccines.
Coverage for most types of commercially available vaccines is primarily provided by Medicare Part D. Medicare Part D is a prescription drug plan, and just like Medicare Part C, Medicare Part D plans are provided by private insurance companies. Medicare Part D provides coverage for many preventive vaccines like tetanus shots.
How Much Do Vaccines Cost?
The cost of a vaccine will vary depending on what type of vaccine you are going to have. A flu shot usually costs around $40. A Hepatitis-B vaccine may cost around $60.
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.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover hormone pellets?