The flu shot is a preventive care treatment for influenza, a highly contagious and potentially deadly disease for seniors and people with comorbidities. While many health insurance plans make you pay a co-pay for the flu shot if you have Medicare, you can get it for free.
In this article, we’ll give you the complete answer to, “Does Medicare cover flu shots?” so you don’t pay a dime out of your own pocket.
Key Takeaways
- The flu (influenza) is a viral infection that can cause coughing, vomiting, fatigue, diarrhea, and a plethora of other horrible symptoms.
- It is important to get the flu shot each year to protect yourself and others from the most common strains of the virus.
- The cost for a flu shot ranges from $20 to $75 without health insurance.
- Medicare will completely cover one flu shot per year for you.
- A Medicare Advantage plan will also completely cover the cost of a flu shot once per year.
- Medicaid covers the seasonal flu shot for its beneficiaries, but terms and conditions can apply depending on the state it is provided.
- Most major pharmacies in your area allow you to get a walk-in flu shot at no cost, as long as you have health insurance like Medicare.
What Is The Flu?
The flu, also known as influenza, is a virus that infects your nose, throat, and lungs. The symptoms of the flu are gradual, starting slowly with coughing and sneezing until it suddenly hits the more aggressive symptoms. Typical symptoms of the flu include:1Mayoclinic.org, “Influenza (flu)“, Accessed November 18, 2021
- Fever
- Aching muscles
- Chills and sweats
- Headache
- Dry, persistent cough
- Shortness of breath
- Tiredness and weakness
- Runny or stuffy nose
- Sore throat
- Eye pain
- Vomiting and diarrhea, but this is more common in children than adults
If you experience any of the following emergency symptoms when infected with the flu, seek medical care as soon as possible:
- Difficulty breathing or shortness of breath
- Chest pain
- Blue lips
- Dehydration
- Ongoing dizziness
- Seizures
- Worsening of existing medical conditions
- Severe weakness or muscle pain
The Importance of the Flu Shot
Some people do not get the flu shot because they don’t feel comfortable getting it or don’t feel that it’s important enough. You’ve likely heard, “There are too many strains of the flu for it to make a difference.” While that is true, the flu shot is actually very important. Here’s proof.
Flu Season (2020 & 2021) Fast Facts
- The flu vaccine prevented 7.5 million influenza illnesses.
- It prevented 3.7 million medical visits due to the flu.
- It prevented 105,000 influenza-associated hospitalizations.
- Most importantly, it prevented 6,300 influenza-associated deaths.
The Centers for Disease Control and Prevention (CDC) recommends anyone who is 65 years or older get the flu shot from their health care provider. If you are a senior, you are at high risk for life-threatening complications, such as pneumonia, if you catch the flu virus. So, even though the annual flu shot may only protect you against the most common flu strains going around, it’s better than not getting the vaccine at all. Right?2CDC.gov, “Vaccine Benefits“, Accessed November 18, 2021
If you suffer from immune system deficiencies or other medical conditions, such as heart disease or hepatitis B, be sure to get medical advice from your primary care physician before getting the flu shot.3CDC.gov, “Reasons to Vaccinate“, Accessed November 18, 2021
Special Note: With the coronavirus pandemic, it’s even more crucial for seniors to get the flu vaccine. Many people have suffered from influenza and coronavirus simultaneously, and the outcome is often bleak.
The Cost of the Flu Shot
The out-of-pocket without insurance cost of the influenza immunization ranges from $20 to $75. Many pharmacies, such as Walgreens, advertise free flu shots, but that is with health insurance.4Goodrx.com, “How Much Does a Flu Shot Cost Without Insurance?“, Accessed November 18, 2021
It is better to pay for the flu shot than not get it if someone is a senior without health insurance that covers it. However, most insurance companies cover the flu vaccination without any copayments.
Does Medicare Pay for the Flu Shot?
The Medicare program is made up of four parts:
- Medicare Part A (hospital insurance)
- Medicare Part B (medical insurance)
- Medicare Part C (Medicare Advantage plan)
- Medicare Part D (prescription drug plan)
You can get the flu shot at different locations, including your doctor’s office and your local pharmacy — contact them for details. If you have a Medicare Advantage plan, contact your plan for their instructions. Most places accept Medicare Advantage plans.5Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 18, 2021
If you have Original Medicare (Part A and Part B), your Part B coverage pays for one flu shot per flu season. It’s one of Medicare’s preventative care benefits. And it’s free!6Medicare.gov, “Flu shots”, Accessed November 18, 2021
Medicare Advantage Plans and the Flu Shot
Medicare Advantage plans are required to pay for the flu shot 100%. This means that those with a Medicare Advantage plan have no deductible, copayments, or coinsurance. The only caveat on getting a free flu shot is that you can only get the flu shot from a qualified health care provider that accepts Medicare.5Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 18, 2021
Medicaid Coverage for Flu Shots
Medicaid is a jointly funded federal and state assistance program, but it is run on a state level, so each state has its own terms and conditions on what vaccines are covered. Those who have Medicaid assistance can receive the seasonal flu shot for free.7Medicaid.gov, “Quality of Care Vaccines“, Accessed November 18, 2021
Free Flu Shots Near Me with Medicare
In most cases, the easiest way to get a flu shot is to go to your local CVS, Walgreens, Rite Aid, Publix, Walmart, Target, or Costco pharmacy, to name just a few. All major pharmacies accept Medicare Part B and Medicare Advantage plans for vaccinations. It’s quick and easy. You don’t even need to make an appointment.8Goodrx.com, “CVS Flu Shot: Learn How to Get a Discounted or Even Free Flu Shot“, Accessed November 18, 2021
Do You Have The Best Medicare Plan?
Ensure you can get annual flu shots as you grow older with a Medicare insurance plan that will cover them. An insurance agent can help you understand the different insurance companies and policies to choose from and know when the enrollment periods are so you can get the Medicare coverage you need without paying a penalty.
You can get additional information on Medicare.gov or reach out to us at MedicareWire for help navigating the complexities of the Medicare program. We specialize in helping people with Medicare, Medigap, and Medicare Advantage plans throughout the country.
Call 1-855-728-0510 (TTY 711) for plan assistance.
If you qualify for Medicare and don't know where to start, MedicareEnrollment.com, an independent HealthCompare insurance broker, has licensed insurance agents who can help you with your Medicare enrollment options, Mon-Fri, 8am-9pm , SAT 8am-8pm EST.
Citations
- 1Mayoclinic.org, “Influenza (flu)“, Accessed November 18, 2021
- 2CDC.gov, “Vaccine Benefits“, Accessed November 18, 2021
- 3CDC.gov, “Reasons to Vaccinate“, Accessed November 18, 2021
- 4Goodrx.com, “How Much Does a Flu Shot Cost Without Insurance?“, Accessed November 18, 2021
- 5Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 18, 2021
- 6Medicare.gov, “Flu shots”, Accessed November 18, 2021
- 7Medicaid.gov, “Quality of Care Vaccines“, Accessed November 18, 2021
- 8Goodrx.com, “CVS Flu Shot: Learn How to Get a Discounted or Even Free Flu Shot“, Accessed November 18, 2021