What vaccines does Medicare cover?

What vaccines doesn’t Medicare Part B cover?

Part B won’t cover all vaccines. But Medicare Part D, the prescription drug coverage you can purchase from private companies that Medicare regulates, will cover many more.

Starting in 2023, the Inflation Reduction Act eliminated all out-of-pocket costs for vaccines that the CDC’s Advisory Committee on Immunization Practices recommends for adults. In the past, you were probably charged a copayment for vaccines billed to your Part D insurer instead of Part B.

The following vaccines are free to people enrolled in a Part D plan or Medicare Advantage plan with prescription coverage:

Hepatitis A. The CDC recommends a hepatitis A shot for children age 12 to 23 months and children age 2 to 18 who weren’t vaccinated earlier. It also recommends the hepatitis A vaccine for adults at increased risk for hepatitis A, including people with chronic liver disease or those who have HIV or work in areas with a risk of infection as well as others at high risk. 

Hepatitis B. Part D covers this shot for those at low risk for hepatitis B.  

RSV. Respiratory syncytial virus (RSV) can lead to pneumonia or bronchiolitis and can worsen other chronic conditions common among older adults, such as asthma and chronic obstructive pulmonary disease (COPD). The FDA recently approved the RSV vaccine for adults 60 and older to help protect against contracting the virus.  

Shingles. The CDC recommends that everyone age 50 or older get the shingles vaccine. It now recommends two doses of Shingrix for adults 50 and older spaced two to six months apart, even if you previously received Zostavax. In 2020, Shingrix replaced Zostavax, which is no longer available in the U.S.

Tdap. This shot protects against tetanus, diphtheria and whooping cough, also known as pertussis. The CDC recommends getting a Tdap or Td booster every 10 years. 

Unless a vaccine is covered via Part B, Part D plans’ formularies usually cover all commercially available inoculations to prevent illness. Even some less-common shots — including those you may need for travel to Africa, Asia, Central and South America, and the Pacific Islands — are usually covered through Part D without deductibles or copayments if the CDC recommends them for your travel.

Keep in mind

Medicare Advantage plans have some restrictions but also must cover the same Part B preventive services without any cost to you if you use an in-network provider. You may be charged if you use an out-of-network provider.

If your Medicare Advantage plan includes drug coverage, it must also cover the Part D vaccines the CDC recommends without cost sharing.

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