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Does Medicare Cover Flu Shots?

by Ethan Bynon, December 7, 2021 — fact checkedA qualified researcher has reviewed the content on this page to ensure it is factually accurate, meets current industry standards, and helps readers achieve a better understanding of Medicare health insurance and Medicare coverage topics. by Andrew Bynon

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.
  • MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. 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 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?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 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:

  1. Medicare 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)
  2. 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 services. (medical insurance)
  3. 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)
  4. 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... (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)..5Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 18, 2021

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. (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 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. . 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, 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.

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 agents who can help you with your Medicare enrollment options.

Citations

  • 1
    Mayoclinic.org, “Influenza (flu)“, Accessed November 18, 2021
  • 2
    CDC.gov, “Vaccine Benefits“, Accessed November 18, 2021
  • 3
    CDC.gov, “Reasons to Vaccinate“, Accessed November 18, 2021
  • 4
    Goodrx.com, “How Much Does a Flu Shot Cost Without Insurance?“, Accessed November 18, 2021
  • 5
    Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 18, 2021
  • 6
    Medicare.gov, “Flu shots”, Accessed November 18, 2021
  • 7
    Medicaid.gov, “Quality of Care Vaccines“, Accessed November 18, 2021
  • 8
    Goodrx.com, “CVS Flu Shot: Learn How to Get a Discounted or Even Free Flu Shot“, Accessed November 18, 2021

Filed Under: What Does Medicare Cover? Tagged With: Illness, Medicare Coverage, Medicare Part B, Preventive Care, Vaccine

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