Almost all commercially available vaccines, when reasonable and necessary to prevent illness, are covered by Medicare. Certain common vaccines are covered under Original Medicare Part B, or an equivalent Medicare Part C Advantage plan, while others are covered through Medicare Part D prescription drug coverage. Read on to learn more about which Medicare Parts cover which vaccines, your potential out-of-pocket costs for vaccines, and some specific vaccine recommendations.
Medicare Part B vaccines
Medicare Part B covers vaccine and vaccine administration for the following diseases and circumstances:
- Flu shots are available for all patients.
- The pneumonia vaccine is available for all patients.
- The Hepatitis B vaccine is available for people at high or intermediate risk.
- COVID-19 vaccines are available for all patients.
Medicare Part D vaccines
Medicare Part D covers all commercially available vaccines when reasonable and necessary to prevent illness, except those covered by Part B. The most common vaccines delivered under Part D in 2023 were RSV, shingles, Tdap, and td. More than 10 million enrollees received a Part D covered vaccine without paying any out-of-pocket costs in 2023, after the Inflation Reduction Act (IRA) eliminated cost sharing and deductibles for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) covered under Medicare Part D. This Act reduced out-of-pocket payments on vaccinations by Medicare-eligible individuals by more than $400 million.
Recommended vaccines for adults over 50
The following table illustrates the recommended vaccines for adults over the age of 50 according to the CDC.
The RSV vaccine
The RSV vaccine is covered under Medicare Part D. Part D covers most commercially available vaccines.
- What is RSV?
- Respiratory syncytial virus (RSV) is a common virus that causes lung and respiratory tract infections. Most children are infected by this virus before the age of 2. In adults and healthy children, symptoms are minor, but severe infections occur in older adults and adults with weakened immune systems. According to the CDC, the RSV vaccine is recommended for all adults 75 and older, plus those between the ages of 60–74 who are at increased risk for severe RSV.
- How much does the RSV vaccine cost?
- Under Medicare Part D, the RSV vaccine costs $0 out-of-pocket when administered by both in-network and out-of-network providers.
The shingles vaccine
The shingles vaccine is covered under Medicare Part D. Part D covers most commercially available vaccines.
- What is shingles?
- Shingles is a painful rash caused by reactivation of the dormant chicken pox virus. Symptoms of shingles include a blistering rash, a painful burning sensation on the skin, itchiness, fatigue, and fever. Nearly one out of three people will develop shingles over the course of their life, and the risk of getting shingles increases as you get older. The CDC recommends that everyone over the age of 60 gets the shingles vaccine.
- How much does the shingles shot cost?
- Under Medicare Part D, the shingles shot costs $0 out-of-pocket when administered by both in-network and out-of-network providers.
The Tdap and Td vaccines
Tdap and Td vaccines are covered under Medicare Part D. Part D covers most commercially available vaccines.
- What are the Tdap and Td vaccines?
- The Tdap vaccine prevents tetanus (T), diphtheria (D), and pertussis (P, also known as whooping cough). The Td vaccine inoculates only against tetanus and diphtheria, as adults are less likely than children to catch whooping cough. Either one or the other as a booster is recommended for adults every 10 years.
- How much do the Tdap and Td vaccines cost?
- Under Medicare Part D, the Tdap and Td vaccines are $0 out-of-pocket when administered by both in-network and out-of-network providers.
Other vaccines
Other vaccines covered by Part D with no out-of-pocket cost due to the IRA include:
- MMR (measles, mumps, rubella)
- Meningococcal disease
- Typhoid fever
- Destination-specific travel vaccines
For more information on getting the most out of your Medicare benefits, visit our blog.
Vaccine frequently asked questions
- What is a vaccine, and how do vaccines work?
A vaccine is a substance that helps the body develop immunity to a disease without causing the disease itself. It works by stimulating the immune system to recognize and fight the pathogen in case of future exposure. - Are vaccines safe?
Yes, vaccines undergo rigorous testing in clinical trials and must meet strict safety standards before they are approved by regulatory agencies like the FDA. Monitoring continues even after they are approved and widely distributed to ensure ongoing safety. - Can vaccines cause side effects?
Like any medication, vaccines can cause side effects, but they are typically mild and temporary, such as soreness at the injection site, fever, or fatigue. Serious side effects are rare but can occur, and healthcare providers monitor for them. - How long does vaccine protection last?
The duration of protection varies by vaccine. Some vaccines provide lifelong immunity after a complete series, while others may require booster shots to maintain effectiveness, like the flu vaccine, which is updated annually. - Do vaccines contain harmful ingredients?
No, vaccines contain safe ingredients such as weakened or inactivated parts of the pathogen (antigens), stabilizers, and preservatives. Ingredients like aluminum and formaldehyde, used in tiny amounts, help enhance the immune response and have been used safely for decades. - Can vaccines overload the immune system?
No, the immune system can handle many vaccines at once. Children and adults are exposed to far more antigens in their daily environments than through vaccinations. - Why are some vaccines given more than once?
Some vaccines, such as the tetanus shot, require boosters because immunity can fade over time. Others, like the MMR vaccine, require multiple doses to ensure full protection. - Are vaccines necessary if the disease is no longer common?
Yes, vaccines help prevent the return of diseases that have been largely eradicated or controlled. Herd immunity protects those who cannot be vaccinated, such as individuals with weakened immune systems, so widespread vaccination is critical. - What should I do if I experience side effects after vaccination?
Most side effects are mild and go away on their own. If you experience severe or unexpected reactions, such as high fever, difficulty breathing, or swelling, seek medical attention immediately. Reporting side effects to the Vaccine Adverse Event Reporting System (VAERS) helps monitor vaccine safety. - Where can I get vaccinated?
Vaccines are available at various locations, including doctors’ offices, local pharmacies, public health clinics, and hospitals. Many health departments also provide free or low-cost vaccinations. - How do I schedule a vaccine appointment?
You can schedule an appointment by contacting your healthcare provider, pharmacy, or local health department. Many providers offer walk-in services or online scheduling, particularly for common vaccines like flu shots. - How do I know which vaccines I need?
Your vaccine needs depend on factors like age, health status, travel plans, and vaccination history. Your healthcare provider can help you determine which vaccines are recommended for you. See the chart above for recommendations regarding vaccinations for adults over 50. - Can I get vaccinated during an illness?
If you have a mild illness, such as a cold, it is generally safe to get vaccinated. However, if you have a moderate or severe illness, it’s best to wait until you recover. Consult with your healthcare provider for guidance.
