Medicare covers RSV shots for adults 60 and older
Medicare Part B covers two RSV vaccines for people aged 60 and up: Arexvy (made by GSK) and Abrysvo (made by Pfizer). Both became available in 2023. You pay nothing out of pocket for the shot itself if you receive it at a Medicare-enrolled provider — Part B covers the full cost after you meet your deductible, or with no deductible at all depending on your plan.
The vaccine is a single dose given as an injection, usually in the upper arm. You do not need multiple shots or boosters. The decision to get one is yours and your doctor's — Medicare covers it, but the shot is not required.
If you have Original Medicare (Part A and B), you are covered. If you have a Medicare Advantage plan, coverage varies by plan, so you will need to check your plan documents or call the plan directly to confirm.
Key Takeaways
- Medicare Part B covers the full cost of either Arexvy or Abrysvo for adults 60 and older at no charge after your deductible is met.
- You receive one dose only — there are no boosters required for RSV vaccination under current Medicare coverage.
- Medicare Advantage plans may cover RSV shots differently, so you should contact your specific plan to confirm coverage before scheduling.
- The vaccine is given at your doctor's office, a pharmacy, or a clinic — any provider enrolled in Medicare can administer it.
Where to get the RSV shot under Medicare
You can receive the RSV vaccine at any location that is enrolled as a Medicare provider and stocks the vaccine. This includes your primary care doctor's office, urgent care clinics, pharmacies (like CVS, Walgreens, or Rite Aid), and hospital outpatient departments. Not every location carries both vaccines, so you may have a choice between Arexvy and Abrysvo depending on where you go.
Call ahead before you visit. Ask whether they have RSV vaccine in stock, which brand they carry, and whether they accept your Medicare plan. This takes five minutes and prevents a wasted trip. If your regular doctor does not stock it, your local pharmacy almost certainly does.
You do not need a referral from your doctor to get the shot, though talking to your doctor first is a good idea if you have questions about whether it is right for you.
What to bring when you get the shot
Bring your Medicare card. That is the main thing the provider needs. If you have a Medicare Advantage plan, bring that card instead. You may also be asked for a photo ID and your date of birth to confirm your identity.
If you have questions about your specific coverage — for example, whether you have already met your deductible this year — ask the provider's billing staff before you receive the shot. They can look up your coverage in real time and tell you whether you will owe anything.
Cost and deductible information
Under Original Medicare Part B, the RSV vaccine itself is covered at no cost once you have met your annual Part B deductible. The deductible amount changes each year — in 2024 it was $240, but confirm the current year's amount with Medicare or your provider. After you meet the deductible, Part B covers preventive vaccines like RSV at 100 percent.
The provider may charge an administration fee (the cost of giving the shot), which is also covered by Part B after your deductible. You should not pay out of pocket for either the vaccine or the administration if you are enrolled in Original Medicare.
If you have a Medigap plan, it may cover your Part B deductible, which means you could owe nothing at all. Check your Medigap policy or call your plan to confirm.
Medicare Advantage plan coverage
Medicare Advantage plans (Part C) are required to cover all vaccines that Original Medicare covers, including RSV shots. However, the way they cover it — the copay amount, whether you need prior approval, which pharmacies or doctors are in-network — varies from plan to plan.
Before you schedule the shot, contact your Medicare Advantage plan directly. Call the number on the back of your card and ask: "Does my plan cover RSV vaccination for people 60 and older, and what is my out-of-pocket cost?" Some plans may require you to use an in-network provider or may ask your doctor to request prior approval first.
If your plan denies coverage or charges you a copay, you have the right to appeal. Keep any paperwork from the provider showing the vaccine was given and what you were charged.
Age and may be able to access for RSV vaccination
Medicare covers RSV shots for anyone 60 years old or older who is enrolled in Medicare. You do not need to have a specific health condition or risk factor — age 60 alone is enough. If you are younger than 60 and enrolled in Medicare due to disability or end-stage renal disease, you are not covered for the RSV vaccine under current Medicare policy.
The vaccine is also available to younger adults and children through other programs, but Medicare's coverage is limited to age 60 and up. If you are under 60 and interested in the vaccine, talk to your doctor about other options or check whether your private insurance covers it.
What happens after you get the shot
After receiving the RSV vaccine, you may experience mild side effects like arm soreness, fatigue, or low-grade fever. These typically go away within a few days. Serious side effects are rare.
Your provider will give you a vaccination record card showing the date, which vaccine you received (Arexvy or Abrysvo), and the lot number. Keep this for your records. You do not need to report the vaccination to Medicare — your provider does that automatically.
You do not need a follow-up appointment or booster shot. One dose is the complete course of RSV vaccination under Medicare.
Frequently Asked Questions
Can I get the RSV shot if I have a Medicare Advantage plan?
Yes, Medicare Advantage plans must cover RSV vaccination for people 60 and older. However, your out-of-pocket cost and whether you need prior approval depend on your specific plan. Contact your plan before scheduling to find out your copay and whether you must use an in-network provider.
Do I need my doctor's permission to get the RSV shot?
No, you do not need a referral or prior approval from your doctor to receive the vaccine at a pharmacy or clinic. However, talking to your doctor first is a good idea if you have questions about whether the vaccine is right for you or if you take medications that might interact with it.
What is the difference between Arexvy and Abrysvo?
Both are single-dose RSV vaccines approved for adults 60 and older. They use different technology — Arexvy is a protein-based vaccine, and Abrysvo uses mRNA — but both are covered by Medicare at no cost. Your choice may depend on which one your provider has in stock or your personal preference after discussing with your doctor.
Will I owe anything if I have not met my Part B deductible?
If you have Original Medicare and have not met your annual Part B deductible, you will owe the deductible amount before Part B covers the vaccine. Once you meet it, the vaccine and administration are covered at 100 percent. If you have a Medigap plan, it may cover your deductible, so check your policy.
Can I get the RSV shot at the same time as other vaccines?
Yes, you can receive the RSV vaccine at the same visit as other vaccines like flu or pneumococcal shots. Your provider can give multiple vaccines in one appointment. There are no spacing requirements between RSV and other vaccines.