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Millions of Medicare Enrollees Get Free Vaccines

AARP-backed prescription drug law eliminated more than $400 million in out-of-pocket costs for RSV, shingles, other vital shots — plus, how women benefit

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More than 10 million Americans with Medicare received a free vaccine in 2023 under a prescription drug law passed in 2022 that eliminates cost sharing for certain vaccines covered under Part D. That’s an increase from 3.4 million who received covered vaccinations in 2021, data from the U.S. Department of Health and Human Services (HHS) shows, and a savings of more than $400 million in out-of-pocket costs for shots that historically were subject to cost sharing — a barrier to vaccine uptake.

Vaccines covered under Part D include shots for conditions that can be especially burdensome for older adults, including shingles and respiratory syncytial virus. RSV sends as many as 160,000 older adults to hospitals each year and kills as many as 10,000, according to the Centers for Disease Control and Prevention.

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A vaccine for RSV was first approved for adults 60 and older in the summer of 2023, and roughly 6.5 million Part D enrollees received it for free that year. A study published in the journal Clinical Infectious Diseases found that the RSV vaccine could cut hospitalizations and deaths in the older population by about 60 percent if its uptake is similar to that of the flu shot.

Nearly 4 million enrollees received a free shingles vaccine in 2023, the federal report found, up from 2.7 million who received the shot in 2021. Shingles sends far fewer adults to the hospital compared with RSV but nevertheless can be serious and even life-threatening — especially for older individuals and people with compromised immune systems.

“Free vaccines are life-changing and lifesaving for millions of Americans’ health and their wallets,” HHS Secretary Xavier Becerra said in a statement.

Inoculations for Tdap — which protects against tetanus, diphtheria and pertussis — and hepatitis A and B can also fall under Part D.

“High out-of-pocket costs prevented far too many older Americans from getting recommended vaccines,” says Leigh Purvis, prescription drug policy principal in AARP’s Public Policy Institute. “The new prescription drug law removes this obstacle and will help protect the health of millions of Medicare beneficiaries.”

Women benefit from Rx law

Eliminating out-of-pocket costs for vaccines is especially beneficial to the millions of Part D enrollees who are women, according to another HHS report, published in April.

In 2021, nearly 2 million of the 3.4 million enrollees who received a vaccine under Part D were women, and they paid approximately $133.4 million in out-of-pocket costs for these vaccines, or about $68 per enrollee. Had the law been in effect in 2021, they would have had no expenses, the report states.


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Women enrollees are expected to benefit in several other ways from the prescription drug law, which in addition to making certain Part D vaccines free, caps insulin out-of-pocket costs for Medicare beneficiaries at $35 for a month’s supply. According to the HHS report, nearly 733,000 female enrollees were taking insulin in 2020. “The reduction in out-of-pocket spending, in turn, may improve access and adherence to prescribed insulin regimens, which may avert hospitalizations and health care complications associated with uncontrolled diabetes,” the report’s authors write.

In combination with other new benefits, the changes to the Part D benefit design under the law — which includes an annual $2,000 out-of-pocket cap for medications beginning in 2025 — are projected to save women enrollees an average of $128 a year. Some women will have savings of $1,000 or more in out-of-pocket costs, according to the report. Women enrolled in Medicare have higher rates of several serious health conditions that require prescription medication, including asthma, Alzheimer’s disease and autoimmune conditions.

The Medicare drug price negotiations will directly impact older women, too. Under the law, Medicare is negotiating the prices of certain medications directly with their manufacturers — starting with a list of 10, and more drugs will be added every year.

In 2022, more than 4.5 million women took at least one of the first 10 drugs selected for negotiation, according to the HHS report, and women with Medicare shelled out $1.55 billion in out-of-pocket expenses for them. The negotiated prices for the first 10 drugs will go into effect in 2026.

“The new prescription drug law is already creating huge savings for millions of Medicare beneficiaries. These benefits will only grow as implementation of this historic law continues,” AARP’s Purvis says.

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