Vaccines are essential for preventing serious disease, particularly for older adults whose immune systems may be less resilient. Medicare provides coverage for a variety of vaccines, but that coverage is divided between Part B and Part D. Knowing which part pays for which vaccine helps you steer clear of surprise expenses.
Vaccines Paid for by Part B
Medicare Part B covers vaccines that are directly tied to treating or preventing specific conditions. The following immunizations are covered at no cost to you (no deductible or coinsurance) under Part B:
Flu (Influenza) Vaccine
- Covered once each flu season
- Includes standard, high-dose, and adjuvanted versions of the flu vaccine
- Administered at doctor's offices, pharmacies, and other approved settings
Pneumococcal (Pneumonia) Vaccine
- Covers both the PCV15 and PCV20 pneumococcal vaccines
- Recommended for every adult aged 65 and older
- No cost when given in accordance with CDC guidelines
COVID-19 Vaccine
- All FDA-authorized and approved COVID-19 vaccines and boosters are covered
- Medicare beneficiaries pay nothing out of pocket
- Available at pharmacies, medical offices, and community vaccination locations
Hepatitis B Vaccine
- Covered for beneficiaries who face a medium to high risk of contracting Hepatitis B
- Risk factors include diabetes, end-stage renal disease, and certain workplace exposures
- Your physician can assess whether you qualify based on your risk profile
Vaccines Paid for by Part D
The majority of other vaccines fall under your Part D prescription drug plan instead of Part B. Commonly covered Part D vaccines include:
- Shingles (Shingrix) vaccine
- Tdap (tetanus, diphtheria, pertussis) vaccine
- Hepatitis A vaccine
- MMR (measles, mumps, rubella) when medically necessary
Part D Vaccine Costs
Because of the Inflation Reduction Act, all Part D-covered vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) are now available at $0 cost for Medicare beneficiaries. This change took effect in 2023 and removed copays for these critical immunizations.
Where You Can Get Vaccinated
Medicare-covered vaccines are offered at numerous locations:
- Your doctor's office
- Retail pharmacies (CVS, Walgreens, Walmart, and others)
- Community health centers
- Hospital outpatient departments
- Local public health clinics
When receiving a Part D vaccine at a pharmacy, the pharmacy can usually bill your Part D plan directly. If they are unable to do so, you may need to pay out of pocket and file a claim with your plan for reimbursement.
Helpful Advice for Medicare Beneficiaries
- Keep current on vaccines recommended for your age group
- Bring your Medicare card and Part D plan card to every vaccination appointment
- Confirm coverage before receiving any vaccine so you understand how it will be billed
- Consult your doctor about which immunizations are appropriate given your health history
- Maintain records of all vaccinations in your personal health file
Preventive immunizations are among the most effective ways to safeguard your health. For a full list of free preventive services, see our dedicated guide. With Medicare covering the cost of most recommended vaccines, there is no financial obstacle to staying up to date on your shots.