Does Medicare Cover Vaccinations?

• by Christian Worstell
• September 13, 2023
• Reviewed by John Krahnert

Medicare Part B does cover preventive vaccinations that include getting flu shots, pneumonia shots, COVID-19 vaccinations and Hepatitis B shots.

Most Medicare Advantage (Part C) plans offer prescription drug coverage, including many commercially available vaccines that Original Medicare (Part A and Part B) doesn’t cover.

What vaccines are covered by Medicare?

The following chart shows how some common vaccines are covered by Medicare.

These are only a few of the most commonly recommended vaccines. Check with your doctor or health care provider if you have questions about a specific immunization or vaccine that is not listed here.

Medicare Part B also typically covers vaccines after you’ve potentially been exposed to a dangerous disease or virus. For example, your rabies shot may be covered by Medicare Part B if you are bitten by a dog.

Does Medicare pay for Tdap immunizations?

Medicare Part B does not typically cover Tdap, which is the adult booster shot for tetanus, diphtheria and pertussis (whooping cough).

Many Medicare Advantage Prescription Drug plans (MAPD) and standalone Medicare Part D prescription drug plans (PDP) cover Tdap.

Does Medicare cover the Hepatitis B vaccine?

Medicare Part B and Medicare Advantage plans will cover injection of the Hepatitis B vaccine if you are considered at medium or high risk for Hepatitis B.

You may have an increased risk if:

• You have hemophilia
• You have End-Stage Renal Disease (ESRD)
• You have diabetes
• You live with another person who has Hepatitis B
• You work in health care and have frequent contact with blood and other bodily fluids

Your doctor can help you determine if you’re at increased risk for contracting Hepatitis B.

Does Medicare cover pneumonia shots?

Medicare Part B typically covers pneumonia (pneumococcal) shots, which help prevent certain types of pneumonia.

Medicare Advantage (Part C) plans also cover pneumonia shots. Many Medicare Advantage plans also cover prescription drugs and other benefits that Medicare Part A and Part B don't cover.

Medicare typically covers 100 percent of the Medicare-approved amount of your pneumococcal vaccine (if you receive the service from a provider who participates in Medicare).

Before getting your pneumonia shot, verify with your doctor that it is 100 percent covered by Medicare.

The Centers for Disease Control and Prevention (CDC) recommends PPSV23 pneumococcal vaccinations for all adults who are 65 years of age or older.

There are currently two pneumococcal vaccines that have been approved for use for the prevention of pneumonia. Both vaccines are covered under Medicare Part B — however, the order in which you receive them matters. Talk to your health care provider to learn more.

Medicare Advantage plans may cover more vaccines than Original Medicare

Medicare Advantage plans are sold by private insurance companies as an alternative to Original Medicare.

Every Medicare Advantage plan must provide the same hospital and medical benefits as Medicare Part A and Part B, and most plans include Medicare prescription drug coverage. Many plans also cover resources such as transportation to and from doctor's offices. 

MAPDs must help cover a number of commercially available vaccines that aren’t covered by Original Medicare when reasonably and medically necessary to prevent illness. However, specific rules of administration and costs (including monthly premiums, deductibles and coinsurance) will vary depending on the Medicare Advantage plan you enroll in.

A licensed insurance agent can help you compare Medicare Advantage plans in your area, including what vaccinations may be covered.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

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.

 

 

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