Reviewed by Hayden Gharibyar, Pharm.D.
Prevnar 13 is an injection used to vaccinate against Streptococcus pneumoniae, or the pneumococcal bacteria which can cause pneumonia and meningitis.
Medicare Part B may cover Prevnar 13 and certain other types of vaccines and preventive medicine.
If Medicare Part B covers your Prevnar 13 shot, a Medicare Advantage plan (Medicare Part C) would also cover Prevnar 13.
Medicare Part B will typically cover your first pneumococcal shot at any time. It will typically cover your second shot as long as it's given at least one year after your first shot.
Medicare Advantage plans (Medicare Part C) are required by law to offer at least the same benefits as Original Medicare (Part A and Part B).
This means that if Medicare Part B covers your Prevnar 13 shot, so would a Medicare Advantage plan.
If you visit a doctor who accepts Medicare assignment, you won't pay anything for your covered Prevnar 13 shot.
Prevnar 13, or the pneumococcal conjugate vaccine, protects against 13 types of pneumococcal bacteria.
The Centers for Disease Control and Prevention (CDC) recommends Prevnar 13 for:
Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.1
Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.
A licensed insurance agent can help you learn more about Medicare Advantage plans that are available where you live, including the benefits they offer. $0 premium plans may be available in your area.
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1 Jacobson, Gretchen; et al. A Dozen Facts About Medicare Advantage. (Nov. 13, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage.
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