Medicare covers the shingles vaccine, but the coverage depends on which part of Medicare you have and which vaccine your doctor gives you.

Medicare Part B covers the Shingrix vaccine (the two-dose series) at no cost to you if you are 50 or older. You pay nothing out of pocket — no copay, no coinsurance, no deductible. Your doctor's office or pharmacy administers it, and Medicare Part B picks up the full bill.

Medicare Part D (prescription drug coverage) covers the older Zostavax vaccine if your plan includes it, though Zostavax is rarely given now because Shingrix is more effective. If you have Part D and your plan covers Zostavax, you may pay a copay depending on your plan.

If you have Medicare Advantage (Part C), your plan must cover Shingrix the same way Part B does — at no cost to you — because Medicare Advantage plans are required to cover all Part B benefits. However, you should call your plan to confirm which pharmacies or doctors are in-network, because using an out-of-network provider may trigger a copay.

Key Takeaways

  • Medicare Part B covers Shingrix (the current shingles vaccine) completely free for people 50 and older, with no copay or deductible.
  • You need two doses of Shingrix, given two to six months apart, and both are covered at no cost.
  • Medicare Advantage plans must cover Shingrix at no cost, but you should use in-network providers to avoid a copay.
  • If you received Zostavax (the older vaccine) before, you can still get Shingrix — there is no waiting period between them.

How to Get the Shingrix Vaccine Under Medicare Part B

Call your primary care doctor's office or a local pharmacy and ask if they administer Shingrix to Medicare patients. Most do. Tell them you have Medicare and want the shingles vaccine. You do not need a referral.

Bring your Medicare card to your appointment. The provider will give you the first dose and schedule you for the second dose, which you return for two to six months later. Both visits are covered at no cost. After your second dose, you are protected against shingles.

Some pharmacies (including many CVS, Walgreens, and Rite Aid locations) give Shingrix without an appointment. You can walk in, show your Medicare card, and get the first dose the same day. Call ahead to confirm they have Shingrix in stock.

What Happens If You Have Medicare Advantage

Your Medicare Advantage plan is legally required to cover Shingrix at no cost, just as Medicare Part B does. However, the plan controls which doctors and pharmacies you can use without paying extra.

Before you schedule your vaccine, call the customer service number on your Medicare Advantage card and ask: "Is Shingrix covered at no cost?" and "Which pharmacies or doctors in my area offer it?" If you use an in-network provider, you pay nothing. If you use an out-of-network provider, you may owe a copay.

Some Medicare Advantage plans have a small copay for vaccines even at in-network locations, though this is uncommon. Your plan documents or customer service line will tell you the exact cost.

Shingrix Versus Zostavax: What You Should Know

Shingrix is the vaccine Medicare now covers. It is a two-dose series given two to six months apart and is about 90 percent effective at preventing shingles. Zostavax, the older single-dose vaccine, is still covered by some Medicare Part D plans but is rarely given anymore because Shingrix works better.

If you received Zostavax in the past, you can still get Shingrix. There is no waiting period. In fact, the CDC recommends that anyone who had Zostavax should get Shingrix later for better protection. You do not need to wait any specific amount of time between the two vaccines.

If you are unsure which vaccine you received before, ask your doctor's office to check your records. They can tell you what you had and whether Shingrix is right for you now.

What to Bring to Your Vaccine Appointment

Bring your Medicare card. That is the main thing you need. Your provider will scan or copy it to bill Medicare Part B directly.

If you have Medicare Advantage, bring your Medicare Advantage card instead. If you have both Part B and Part D, bring both cards, though Part B will be used for Shingrix.

You do not need a referral, a prescription, or prior authorization. Walk in or call to schedule, and Medicare will cover the cost at the point of service.

If Your Doctor Says You Should Not Get Shingrix

A small number of people should not get Shingrix — for example, if you have a severe allergy to any ingredient in the vaccine or if you are currently very ill with a high fever. Your doctor will tell you if this applies to you.

If your doctor says you should wait or that Shingrix is not right for you, ask them to document that in your medical record. You can then show that documentation to Medicare or your Medicare Advantage plan if questions come up later.

If you disagree with your doctor's assessment, you can ask for a second opinion from another doctor. Medicare covers the cost of that visit just as it covers any other doctor visit.

Frequently Asked Questions

Do I have to get both doses of Shingrix, or can I get just one?

You need both doses for full protection. Medicare covers both. The second dose should be given two to six months after the first. If you get only one dose, you are not fully protected against shingles.

What if I am under 50 — does Medicare cover Shingrix for me?

Medicare Part B covers Shingrix only for people 50 and older. If you are under 50 and have Medicare (for example, because of a disability), ask your doctor whether Shingrix is right for you and what it will cost. Some private insurance plans cover it for younger people.

Can I get Shingrix at the same time as other vaccines like the flu shot?

Yes. You can get Shingrix and other vaccines (flu, pneumonia, COVID-19) at the same appointment. They are given as separate injections in different arms. Medicare covers all of them.

What if I had shingles in the past — can I still get Shingrix?

Yes. You can get Shingrix even if you had shingles before. In fact, the CDC recommends it, because you can get shingles more than once. Wait until the shingles rash is completely gone before getting the vaccine.

Will Medicare cover Shingrix if I get it at a pharmacy instead of a doctor's office?

Yes. Pharmacies that administer Shingrix to Medicare patients bill Medicare Part B directly. Bring your Medicare card, and you pay nothing. Make sure the pharmacy is in-network if you have Medicare Advantage.