According to the Centers for Disease Control, 1 out of 3 people in the United States will contract shingles in their lives.
While many only get it once, some people contract it multiple times. The rates of incidence have been increasing over the years and no one knows exactly why.
Shingles can impact anyone, young or old. Although it’s more common among the elderly population, and also more problematic.
That said, getting the shingles vaccine, especially if you are elderly, immunocompromised, or both just makes sense.
But does Medicare cover the shingles vaccine?
The short answer is yes. Read on and we’ll tell you everything you need to know.
Medicare Does Cover the Shingles Vaccine
Although, how Medicare covers the vaccine will depend on your specific plan.
If you have coverage under Original Medicare, Medicare Part A (hospital insurance), and Medicare Part B (medical insurance), Medicare Part B will cover the cost of the office visit but not the vaccine itself. So expect to pay for the vaccine out of pocket.
If you are enrolled in a Medicare Advantage plan with Part D or Medicare Part D (prescription drug) plan, then you will be able to get one of the two commercially available shingles vaccines, Shingrix or Zostavax.
Shingrix is the new shingles vaccine. Zostovox will no longer be produced after July 2020. Some pharmacies may still have a supply available, but Shingrix is now the defacto shingles vaccine and is what the CDC recommends.
How Can I Get the Shingles Vaccine?
The shingles vaccine can be obtained two ways; at your primary care physician’s office, or at your pharmacy.
At Your Primary Care Physician’s Office
Before you go, ask your doctor’s office if you can receive the vaccine without a copay charge from the doctor. Most Medicare Advantage plans will allow this, but an office visit on Original Medicare will charge you for both the visit and the vaccine, likely costing you hundreds of dollars. If you check beforehand, it won’t be a surprise.
At Your Pharmacy
Most major pharmacy chains, and some smaller, independent pharmacies, are also able to administer the shingles vaccine. If you have Part D, this is where you’ll go.
You will still need a prescription from your doctor and you’ll need to ensure that the pharmacy you choose is in your network. That way they can bill your plan and you’ll only be paying your copayment. Don’t forget, with Medicare Part D you must pay your annual deductible before the plan starts paying its share.
It Pays to Be Protected
There you have it. Does Medicare cover the shingles vaccine?
Yes. Through Medicare Part C and Part D, you can get the shingles vaccine shot.
Although Medicare Part D is optional, if you don’t sign up for it when you are first eligible and decide to sign up later, you could pay extra.
Getting coverage for common vaccines, like shingles, makes it worth it even if you don’t take prescriptions.