Does Medicare Cover Tetanus Shots?
- January 12, 2024
- Reviewed by John Krahnert
While Medicare Part A and Part B (Original Medicare) do not cover tetanus shots, Medicare Part D prescription drug plans and Medicare Advantage (Part C) plans that include drug coverage can cover tetanus shots.
According to Medicare.gov, the official website of the Centers for Medicare & Medicaid Services (CMS), Medicare prescription drug coverage “usually covers all commercially available vaccines needed to prevent illness, including the Tdap shot.”
Medicare Advantage plan benefits can vary, and plans that include Part D drug coverage may not be available where you live. A licensed insurance agent can help you find out if plans available in your area cover prescription drugs and whether they cover tetanus shots.
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
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How does Medicare cover tetanus vaccines?
Medicare Part A and Part B (Original Medicare) do not cover the tetanus vaccination for prevention of infection. This means that any Medicare coverage of the Tdap vaccine will come from:
- A Medicare Advantage plan that includes prescription drug coverage
- A standalone Medicare Part D plan
Both types of plans are sold by private insurance companies, and the specific benefits and availability may vary based on where you live.
The Tdap vaccine is the booster shot for adults and adolescents. It is recommended every 10 years for all adults with prior immunization against tetanus.
If you are exposed to tetanus through an injury, Part B – in limited circumstances – can provide coverage for the tetanus immunization if your situation meets certain requirements.
Is Tdap covered by Medicare?
Tdap is an acronym for tetanus, diphtheria and pertussis, and the vaccine for all three diseases are typically included in one shot called the Tdap. As mentioned above, the Tdap vaccine is not covered by Original Medicare but can be covered by a Medicare Advantage Prescription Drug (MA-PD) plan or Medicare Part D plan.
Depending on your plan, you could potentially face out-of-pocket costs or restrictions such as:
- Coinsurance or copayments
- Deductible
- Plan network restrictions
Speak with your plan carrier directly for specific cost and coverage information.
Compare Medicare Advantage plans where you live
Medicare Advantage plans are an alternative plan to Original Medicare that are sold by private insurance companies.
Call to speak with a licensed insurance agent who can help compare Medicare Advantage plans in your area, including what they cover and their associated costs.
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.
