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.
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 to get the flu shot from their health care providerA person or organization that’s licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers..... 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?
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.
Special Note for 2021: 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 $70. Many pharmacies, such as Walgreens, advertise free flu shots, but that is with health insurance.
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 copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service.....
Does Medicare Pay for the Flu Shot?
The Medicare program is made up of four parts:
- Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care.... (hospital insurance)
- Part B (medical insurance)
- Medicare Part CMedicare Part C is Medicare's private health plan option. Also known as Medicare Advantage, Medicare Part C plans are a type of Medicare health plan offered by companies that contract with Medicare to provide all... (Medicare Advantage plan)
- Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... Plan (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 plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).....
If you have Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage...., your Part B coverage, the medical insurance part of Medicare, pays for one flu shot per flu season. It’s one of Medicare’s preventative care benefits. And it’s free!
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.
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 deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share...., copayments, or coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. ....
Medicaid Coverage for Flu Shots
MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States.... is a state-run program, so each state has its own terms and conditions. Those who have Medicaid assistance can receive the seasonal flu shot for free.
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 BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare... (for vaccinations) and Medicare Advantage plans. It’s quick and easy. You don’t even need to make an appointment.
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 periodsEnrollment periods are designated time periods to enroll or disenroll from the various parts of Medicare. There are six Medicare 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 MedicareWireMedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer.... for help navigating the complexities of the Medicare program. We specialize in helping people with Medicare, MedigapMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage...., and Medicare Advantage plans throughout the country.
Citations & References:
cdc.gov
- Who Needs a Flu Vaccine and When | CDC
https://www.cdc.gov/flu/prevent/vaccinations.htm - Healthy Habits to Help Prevent Flu | CDC
https://www.cdc.gov/flu/prevent/actions-prevent-flu.htm - Influenza (Flu) | CDC
https://www.cdc.gov/flu/
medicare.gov
- Flu Shots Coverage
https://www.medicare.gov/coverage/flu-shots - Flu Shots Coverage
https://www.medicare.gov/coverage/flu-shots.html - https://www.medicare.gov/Pubs/pdf/11036-Enrolling-Medicare-Part-A-Part-B.pdf
cms.gov
- Preventive Services | CMS
https://www.cms.gov/Medicare/Prevention/Immunizations/index.html?redirect=/Im… - Non-Emergency Medical Transportation | CMS
https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-… - Flu Shot | CMS
https://www.cms.gov/flu-provider
vaccines.gov
- Where to Go | Vaccines
https://www.vaccines.gov/getting/where - Flu (Influenza) | Vaccines
https://www.vaccines.gov/diseases/flu - Adults Age 65 and Older | Vaccines
https://www.vaccines.gov/who_and_when/adults/seniors
walgreens.com
- Health Records and Billing | In-store Clinics | Walgreens
https://www.walgreens.com/pharmacy/healthcareclinic/insurance-and-prices.jsp - Medicare: Is the Flu Shot Covered? | Health Answers | Walgreens
https://www.walgreens.com/health/p2/a/900002/medicare-is-the-flu-shot-covered… - https://www.walgreens.com/images/adaptive/si/pdf/immunizations/WAG_VAR_Form_E…