Medicare covers the RSV vaccine for adults 60 and older at no cost to you

Yes. Medicare Part B covers the RSV vaccine for people aged 60 and older. You pay nothing out of pocket — no copay, no coinsurance, no deductible. The vaccine is covered whether you have Original Medicare (Part A and B) or Medicare Advantage (Part C), though the way you receive it may differ slightly between the two.

The vaccine became available in 2023, and Medicare added it to its covered preventive services in 2024. It is given as a single injection, usually in the arm, and protects against respiratory syncytial virus (RSV), which causes serious respiratory illness in older adults.

You do not need a referral to get the vaccine. You can walk into any pharmacy, doctor's office, or clinic that stocks it and ask for it by name. Medicare will cover the cost automatically when the provider bills your insurance.

Key Takeaways

  • Medicare Part B covers the RSV vaccine at no cost for adults 60 and older, with no deductible or copay required.
  • The vaccine is available at pharmacies, doctor's offices, and clinics — you do not need a referral from your primary care doctor.
  • Medicare Advantage plans must cover the vaccine at the same cost as Original Medicare, though you should check your plan's provider network first.
  • You only need one dose of the RSV vaccine; a second dose is not part of the standard schedule.

How to get the vaccine under Original Medicare

Call ahead to the pharmacy or doctor's office where you want the vaccine and confirm they have it in stock. Not every location carries it yet, though availability is expanding. Tell them you have Medicare and want the RSV vaccine.

Bring your Medicare card when you go. The provider will bill Medicare Part B directly. You will not pay anything at the time of service. The entire process takes about 15 minutes.

If your doctor recommends you wait or suggests a specific timing based on your health history, follow that guidance. For most people, one dose is sufficient. There is no booster dose required at this time.

RSV vaccine coverage under Medicare Advantage

Medicare Advantage plans are required by law to cover the RSV vaccine at the same cost as Original Medicare — which means zero cost to you. However, the vaccine must be given by a provider in your plan's network.

Before you go, call your Medicare Advantage plan's customer service number (on the back of your card) and ask which pharmacies or clinics in your area stock the RSV vaccine. Some plans have preferred locations. If you go to an out-of-network provider, you may be charged.

Bring your Medicare Advantage card, not a separate Medicare card. The provider will verify your coverage and bill your plan directly.

What happens if you are under 60

Medicare does not cover the RSV vaccine for people under 60. If you are younger than 60 and have Original Medicare (which is rare but possible if you may have access to due to disability or end-stage renal disease), the vaccine is not covered.

If you are under 60 and interested in the RSV vaccine, ask your primary care doctor whether it might be recommended for you based on your specific health conditions. Some private insurance plans cover it for younger adults with chronic lung disease, heart disease, or weakened immune systems, but coverage varies widely.

Common reasons the vaccine might not be covered

The vaccine is covered for all Medicare beneficiaries 60 and older, but a few situations can create confusion. If a provider tells you there is a cost, it usually means one of three things: they are billing the wrong insurance, they are out of network for your Medicare Advantage plan, or there is a billing error.

Ask the provider to verify your Medicare coverage before you leave. If they cannot resolve it on the spot, contact your Medicare plan directly. Do not pay out of pocket and then try to get reimbursed — it is much simpler to fix the billing before you receive the vaccine.

If you have both Medicare and Medicaid (dual coverage), Medicare is the primary payer for the RSV vaccine, so your Medicare coverage applies first.

Where to find the vaccine near you

Major pharmacy chains including CVS, Walgreens, and Rite Aid carry the RSV vaccine at many locations. Call your local pharmacy and ask if they have it in stock and whether they accept Medicare.

Your primary care doctor's office may also have it available. Some community health centers and urgent care clinics stock it as well. If you call and a location does not have it, ask when they expect to receive it — supply has been increasing steadily.

You can also search the vaccine finder tool on the CDC website, though not all locations update it when ready. A phone call to confirm availability is usually faster.

What to expect after you get the vaccine

Most people have no side effects or only mild ones. Common reactions include soreness at the injection site, fatigue, or mild muscle aches for a day or two. Serious side effects are rare.

You do not need to do anything special after the vaccine. You can return to your normal activities right away. If you develop a high fever or severe allergic reaction in the hours after vaccination, contact your doctor or go to an urgent care clinic.

Frequently Asked Questions

Do I need to get the RSV vaccine if I already had RSV?

Having RSV in the past does not prevent you from getting it again. The vaccine is still recommended for adults 60 and older, even if you have had RSV before. Your doctor can advise you on timing if you recently had RSV illness.

Can I get the RSV vaccine at the same time as other vaccines?

Yes. The RSV vaccine can be given at the same visit as the flu shot, pneumococcal vaccine, or other vaccines. They are usually given in different arms. Tell the provider which vaccines you want so they can plan accordingly.

What if my Medicare Advantage plan says the vaccine is not covered?

Contact Medicare directly at 1-800-MEDICARE to report this. All Medicare Advantage plans are required to cover the RSV vaccine at no cost for people 60 and older. If your plan is denying coverage, Medicare can intervene. Get the plan's denial in writing before you call.

Is the RSV vaccine covered if I travel outside the United States?

Medicare does not cover services outside the U.S., including vaccines. If you are traveling and want the RSV vaccine abroad, you will pay out of pocket. It is usually less expensive to wait until you return home and get it covered by Medicare.

Will getting the RSV vaccine affect my Medicare premiums?

No. Preventive vaccines covered by Medicare do not increase your premiums. Your Part B premium is based on your income and enrollment status, not on which preventive services you use.