Zostavax® Medicare Coverage

Zostavax®
Typical dosage: 0.65mg

Typical type: Injection1

Zostavax® is a medication typically used to prevent shingles in patients 50 years of age and older. It is available as brand name only and is a subcutaneous injection.

Zostavax is a prescription medication that contains a zoster vaccine to protect against shingles.

Zostavax is a single dose, subcutaneous injection given in the fatty part of the skin. It is given one time and is indicated for adults 50 years of age and older.

Zostavax is a live vaccine that creates antibodies against the zoster infection.

The most common side effects of Zostavax include pain, redness, swelling and irritation where the shot is given, as well as itching and headache.

Does Medicare cover Zostavax?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Zostavax.1

  • 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.2

  • 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.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Zostavax.

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Average costs for Zostavax with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$Free – $241 $Free – $241

Additional information

Zostavax is administered by a licensed healthcare provider only. You can receive Zostavax from your doctor’s office or local community pharmacy. Talk to your doctor about the availability of Zostavax in your area.

Vaccination should be delayed if you have a moderate or severe illness with or without fever or tuberculosis. Because this is a live vaccine, you should avoid close contact with pregnant women, newborns or people with weak immune systems for a period of time.

Vaccination with Zostavax does not guarantee immunity from the shingles virus.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.