1 Freed M, et al. (Nov. 15, 2023). Medicare Advantage 2024 Spotlight: First Look. Kaiser Family Foundation. https://www.kff.org/medicare/issue-brief/medicare-advantage-2024-spotlight-first-look.
Coverage
Does Medicare Cover the Shingles Vaccine (Shingrix)?
- January 12, 2024
- Reviewed by John Krahnert
Original Medicare (Parts A and B) does not cover the shingles vaccine (Shingrix). Find out if a Medicare Advantage (Part C) plan near you that offers prescription drug coverage covers the shingles vaccine.
While Original Medicare (Medicare Part A and Part B) does not cover the shingles vaccine, called Shingrix, Medicare Advantage (Part C) plans can cover prescription drugs such as the shingles vaccine. Medicare Advantage plans that cover prescription drugs may not be available where you live, however.
Medicare Part B covers vaccines for the flu, Hepatitis B and the pneumococcal (pneumonia) vaccine, but Part B does not cover the shingles vaccine.
Shingles shots can be covered by the prescription drug benefits offered by Medicare Part D and Medicare Advantage Prescription Drug (MA-PD) plans.
According to the Kaiser Family Foundation, 89% of 2024 Medicare Advantage plans offer prescription drug coverage.1
It’s important to note these benefits aren’t available with all plans, and some or all of the plans in your area may not cover the shingles shot. According to the Centers for Medicare & Medicaid Services (CMS), the Medicare drug benefits offered by Part D plans and MA-PD plans “usually cover all commercially available vaccines needed to prevent illness, like the shingles shot.”
If you have already have Medicare drug coverage, contact your plan carrier directly to learn about your plan benefits.
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
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What options are there for the Shingles vaccine?
The Centers for Disease Control & Prevention (CDC) recommends two doses of (recombinant zoster vaccine, or RZV) two to six months apart for immunocompetent adults aged 50 years and older.
Does Medicare cover Shingrix or Zostavax?
Medicare Advantage plans that cover shingles vaccines can cover Shingrix. As of November 18, 2020, however, Zostavax is no longer available in the U.S.
How much does the shingles vaccine cost with Medicare drug coverage?
Medicare plans that offer prescription drug coverage aren’t permitted to charge a coinsurance fee or apply a deductible for vaccines recommended by the Advisory Committee on Immunization Practices, which includes zoster (the shingles vaccine).
What is Shingrix?
The Centers for Disease Control and Prevention (CDC) recommends Shingrix for people at or over the age of 50. Shingrix is a double-dose vaccine that is administered with a pair of shots in the upper arm that are generally given within 2-6 months apart.
Shingrix is currently not recommended for people with compromised immune systems or those who are taking moderate to high doses of drugs that suppress the immune system.
Shingrix is also not recommended for anyone with a severe allergy to any component of the drug, and anyone who currently has shingles should wait until symptoms resolve before getting the shot.
What is shingles?
Shingles is a viral infection that causes a painful rash or blisters typically on the torso and back. It is caused by the same virus that causes chickenpox: the varicella-zoster virus.
If you’ve had chickenpox, the virus remains dormant in your body and can reawaken later in life as shingles. In addition to the pain and itching stemming from the rash, shingles can also bring on a fever, fatigue and headaches.
The exact reason for the virus re-emerging as shingles remains unclear, but it’s much more common in older adults and people with a weakened immune system. Shingles is contagious through direct contact with the rash or blisters but is only contagious to people not immune to chickenpox.
If a person catches the virus from someone else, it will develop as chickenpox and not as shingles.
Compare Medicare Advantage plans where you live
Call to speak with a licensed insurance agent or compare plans online today to find out if a Medicare Advantage plan is available where you live that covers prescription drugs including the shingles vaccine.
About the author
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
