Medicare covers the shingles shot at no cost to you

Yes. Medicare Part B covers the shingles vaccine (Shingrix) with no copay, coinsurance, or deductible if you are 50 or older. You do not pay anything out of pocket for either dose. The vaccine is given as two shots, two to six months apart.

This coverage applies whether you are on Original Medicare, Medicare Advantage, or both. If you have a Medigap plan, it does not affect your shingles vaccine coverage — Medicare Part B pays the full cost either way.

You do not need a referral from your doctor to get the vaccine. You can walk into most pharmacies that give vaccines — CVS, Walgreens, Rite Aid, and many independent pharmacies — and ask for Shingrix. Some doctors' offices also give it. Either way, Medicare pays the pharmacy or clinic directly.

Key Takeaways

  • Medicare Part B covers both doses of Shingrix with zero cost to you if you are 50 or older.
  • You need two shots given two to six months apart; both are fully covered.
  • You can get the vaccine at any pharmacy or doctor's office that stocks Shingrix — no referral needed.
  • If you had the older shingles vaccine (Zostavax) in the past, you can still get Shingrix; Medicare covers it regardless of prior vaccination.
  • Tell the pharmacy or clinic that you have Medicare so they bill it correctly before you receive the shot.

Where to get the shingles vaccine

You have several options for where to receive Shingrix. Most people go to a pharmacy because it is fast and does not require an appointment at many locations. Call ahead to confirm the pharmacy has the vaccine in stock and ask when they can fit you in.

Your doctor's office may also give Shingrix. If you see your primary care doctor regularly, you can ask during your next visit whether they offer it. Some offices give it on the spot; others ask you to schedule a separate vaccine appointment.

Federally may have access to health centers (FQHCs) and community health clinics often have the vaccine available. If you do not have a regular doctor, these clinics can give you Shingrix and will know how to bill Medicare.

Bring your Medicare card with you. The provider needs your Medicare number to bill correctly. If you have a Medigap or Medicare Advantage plan, bring that card too, though it will not change what you pay — Medicare Part B covers the full cost.

The two-dose schedule and timing

Shingrix requires two shots. The second dose should be given two to six months after the first. You do not have to wait the full six months — two months is the minimum gap. Many people get the second shot at two or three months because it is faster.

Both doses must be Shingrix. The older vaccine, Zostavax, is no longer used, but if you received Zostavax years ago, you can still get Shingrix. Medicare covers it even if you were vaccinated before.

If you get the first dose and then forget when your second dose is due, ask the pharmacy or clinic to send you a reminder. Some pharmacies do this automatically. You can also call them to schedule the second appointment right after your first shot.

There is no upper age limit for the vaccine. If you are 50 or older and have not had Shingrix, Medicare covers it at any age.

What happens if you have a Medicare Advantage plan

Medicare Advantage plans (Part C) must cover all Part B preventive services, including Shingrix, with no cost to you. This means your copay is zero even though you are in a private plan instead of Original Medicare.

Some Medicare Advantage plans have preferred pharmacies or clinics where you should get the vaccine to avoid any billing confusion. Check your plan's website or call the customer service number on your card to find out whether there are preferred locations in your area.

You still bring your Medicare Advantage card to the pharmacy or clinic. They will bill your plan, which must pay the full cost. You pay nothing.

If you have already had shingles

You can get Shingrix even if you have had shingles before. In fact, the vaccine can help prevent shingles from coming back, since some people get it more than once. Medicare covers the vaccine regardless of whether you have had the disease.

If you currently have shingles (an active rash), wait until the rash is gone before getting vaccinated. Once you have recovered, you can get Shingrix. There is no waiting period after recovery — you can get vaccinated as soon as you feel ready.

Frequently Asked Questions

Do I need my doctor's permission to get the shingles shot?

No. You do not need a referral or permission from your doctor. You can go directly to a pharmacy or clinic and ask for Shingrix. However, if you have medical conditions or take medications that might interact with the vaccine, it is a good idea to mention this to the pharmacist or nurse before they give the shot.

What if the pharmacy says Medicare will not cover it?

This is rare, but if it happens, ask the pharmacy to contact Medicare directly to verify coverage. You can also call Medicare at 1-800-MEDICARE (1-800-633-4227) to confirm that Shingrix is covered under your plan. Write down the date, time, and name of the person you spoke with at the pharmacy so you have a record.

Can I get both doses at the same visit?

No. The two doses must be given at least two months apart. Getting them on the same day does not work and is not recommended. Plan to return two to six months after your first shot for the second dose.

Will I have side effects from the shingles vaccine?

Some people have mild side effects like arm soreness, fatigue, or a low fever for a day or two after the shot. Serious side effects are rare. The pharmacist or nurse will give you information about what to expect and what to do if you have concerns after the vaccine.

What if I am on a Medigap plan — do I still pay nothing?

Yes. Medigap plans do not affect your shingles vaccine coverage. Medicare Part B pays the full cost, and you pay nothing. Your Medigap plan does not need to approve it or pay anything toward it.