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Will Medicare pay for my flu shot?


Yes. Medicare Part B, which covers doctor and outpatient services, pays for one flu shot each flu season, which starts in the fall and continues through winter and early spring.

Considering flu shots as free preventive services, Part B covers the immunization without any deductibles or copayments as long as you use a provider or pharmacy that accepts Medicare assignment. This means that either of them has agreed to accept the Medicare-approved payment as full reimbursement for the shot.

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If you have coverage through a private Medicare Advantage plan, rather than original Medicare, that plan also must pay for one flu shot per season without any deductibles or copayments. Medicare Advantage may require you to use an in-network provider or pharmacy.

When should I get my influenza vaccination?

The Centers for Disease Control and Prevention (CDC) recommends that most people 6 months and older get a flu shot each flu season, ideally in September or October, so it can be fully effective when cases begin to rise every October. The CDC recommends adults 65 years and older get immunized with a high-dose or adjuvanted vaccine.

People 65 and older are at a higher risk of serious complications if they get the flu, including bacterial pneumoniaear infections and sinus infections. It also can worsen chronic conditions such as asthma, congestive heart failure or diabetes.

This guidance to get a high-dose or adjuvanted vaccine is new for the 2022 flu season. These types of vaccines offer greater protection to older adults, many with weakened immune systems because of age, CDC officials say. Older adults’ immune systems also build up fewer antibodies in response to standard vaccine doses, and those antibodies stay around for a shorter time compared with younger people.

An adjuvant is a vaccine ingredient that helps promote a better immune response. It also can reduce the amount of virus needed for production of a vaccine, which can allow for greater supplies of the vaccine.

What types of flu vaccine are available?

While powerful vaccines have been around for a while, this is the first time they’ve been recommended for people 65 and older. The three types of high-dose vaccines are:

Fluad quadrivalent. This shot is an inactivated vaccine that consists of virus particles that have been grown in culture and then killed to destroy their disease-producing capacity, unlike live vaccines that use live pathogens. It’s approved for people 65 and older to protect against influenza virus subtypes A and types B.

It has the same amount of antigen as the standard shots but contains an adjuvant. The antigen is the part of the vaccine that helps your body build up protection against flu viruses, according to the CDC.

Flublok quadrivalent. Approved for people 18 and older and recommended for those 65 and older, this is a recombinant vaccine, which means it’s manufactured by using a small piece of DNA from bacteria or yeast cells.

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Fluzone high-dose quadrivalent. This vaccine, also made from inactivated cultures and approved for people 65 and older, has four times the antigen of standard-dose inactivated flu vaccines.

As with any vaccine, the high-dose and adjuvanted flu vaccines may result in temporary, mild side effects typical of standard-dose seasonal flu shots. Expected side effects can include pain, redness or swelling at the injection site, fatigue, headache and muscle ache. These symptoms typically go away within one to three days.

Keep in mind

You can get your flu shot at the same time as your COVID-19 vaccine or booster shot. Medicare beneficiaries also can receive the COVID-19 vaccine without any deductibles or copayments, whether they’re enrolled in original Medicare or Medicare Advantage.

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Video: CDC Director Explains Why Skipping the Flu Shot Is a Bad Idea

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