Vaccines play a crucial role in preventing a number of serious infectious diseases. Luckily, Medicare covers the cost of most vaccines. But Medicare itself is made up of four different parts, so it's helpful to know which parts cover which vaccines.
Overview of Medicare
Medicare has four parts:
- Part A: covers hospital stays.
- Part B: covers doctor visits and preventive services.
- Part C: Medicare Advantage plans include Parts A and B, often bundled with extra benefits like dental, vision and hearing coverage.
- Part D: covers prescription drugs.
Vaccine coverage generally falls under two parts of Medicare; Parts B and D. Let's take a look at how each part can help you access these vital immunizations.
Which Vaccines Are Covered by Medicare Part B?
Medicare Part B is the medical insurance portion of Medicare. It helps pay for doctor visits, outpatient care and some preventive services, including some vaccines. Medicare Part A (hospital insurance) and Part B together make up what's called Original Medicare. Original Medicare is provided by the federal government.
Medicare Part B will cover vaccines for the following conditions, among others:
- Flu
- Pneumonia
- Hepatitis B (for people at medium or high risk for Hepatitis B)
- COVID-19
You won't pay anything for these vaccines as long as your provider accepts Medicare. If you have Original Medicare, be sure to bring your red, white and blue Medicare card with you to your appointment.
Which Vaccines Are Covered by Medicare Part D?
Medicare Part D is the prescription drug portion of Medicare. You can get Medicare Part D through a standalone prescription drug plan or through a bundled Medicare Advantage (Part C) plan. Part C and Part D plans are provided by private insurance companies.
Part D plans cover all the vaccines that the Advisory Committee on Immunization Practices (ACIP) recommends, unless they are covered by Part B.
Medicare Part D will cover vaccines for the following conditions:
- Shingles
- RSV (Respiratory Syncytial Virus)
- Tetanus
- Whooping cough
- Diptheria
- Hepatitis A
- Hepatitis B (if not covered under Part B)
- Others considered reasonably necessary to prevent illness.
Your Part D plan formulary will list all the vaccines that are covered by the plan. Be sure to discuss your vaccination needs with your healthcare provider. Their recommendations can vary depending on your health status and medical conditions.
As healthcare research continues, new vaccines may be developed. These advancements could affect Medicare’s coverage in the future. Keeping up with these changes ensures you can make the best health choices. Understanding your Medicare coverage is essential to maintain your health - and to protect the health of your loved ones and friends.
Frequently Asked Questions
Does Medicare Cover the RSV Vaccine?
RSV is a respiratory Medicare Part D will cover the cost of the RSV vaccine. If you only have Original Medicare (Parts A and B), it won’t be covered. The CDC recommends the RSV vaccine for everyone over 75, and some adults ages 60-74. Medicare Part D will cover the cost of the RSV vaccine.
Does Medicare Cover the Shingles Vaccine?
Medicare Part D will cover the cost of the shingles vaccine. For more information, speak with your healthcare provider and explore the CDC recommendations on the Shingles vaccine.
Medicare Prescription Drug Coverage
Wellcare has a low-cost PDP plan available in your area. Our plans offer affordable coverage on thousands of prescription drugs to support your health and help you live a healthier life. The formulary lists the medications we cover.
Call us today to learn more and enroll.
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- Does Medicare Cover Eye Exams?
- Does Medicare Cover Glasses?
- Does Medicare Cover Hearing Aids?
- 5 Things to Know About Medicare Hospice Benefits
- Does Medicare Cover Mental Health Services?
- Does Medicare Cover COVID-19 Tests?
- Does Medicare Cover Diabetic Supplies?
Sources
- CDC.gov: How to Pay for Vaccines
- CDC.gov: Shingles Vaccine Recommendations
- CDC.gov: RSV Vaccine Guidance for Older Adults
- CDC.gov: ACIP Vaccine Recommendations and Guidelines
- Medicare.gov: Hepatitis B Shots
Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.“ Wellcare” is issued by WellCare Prescription Insurance, Inc.
