Medicare covers shingles shots, but the details depend on which Medicare plan you have and which vaccine your doctor recommends
Medicare Part B covers the shingles vaccine (Shingrix) at no cost to you if you are 50 or older — you pay nothing for the shot itself, and Medicare pays the provider's full fee. Part D plans cover it differently and may charge you a copay. If you have a Medigap or Medicare Advantage plan, your coverage works through those plans' rules, not directly through Original Medicare. The vaccine requires two doses given two to six months apart, and both doses are covered.
The vaccine that Medicare covers is Shingrix, a two-dose series. An older vaccine called Zostavax is no longer recommended by the Centers for Disease Control and Prevention (CDC), even though some people received it years ago. If you had Zostavax in the past, you can still get Shingrix — the CDC recommends waiting at least 12 months after Zostavax before getting Shingrix, though some people get it sooner on their doctor's information.
Key Takeaways
- Medicare Part B covers Shingrix at no cost if you are 50 or older, with no copay or deductible for the vaccine itself.
- You need two doses of Shingrix, given two to six months apart, and both are covered by Medicare Part B.
- If you have a Medicare Advantage or Part D plan, check with your plan first because coverage rules and copays vary by plan.
- You can get Shingrix from your primary care doctor, a pharmacy, or a clinic — any provider that stocks the vaccine and accepts Medicare.
- If you had the older Zostavax vaccine, you can still get Shingrix, usually at least 12 months later.
How Medicare Part B covers the shingles vaccine
Under Medicare Part B, Shingrix is covered as a preventive service with no copay, coinsurance, or deductible. This means you do not pay anything out of pocket for the vaccine dose itself. Medicare pays the provider directly for the vaccine and the administration fee (the cost of giving you the shot).
You do need to make sure your provider is enrolled in Medicare and accepts Medicare payment. Most primary care doctors, pharmacies, and urgent care clinics do, but it is worth confirming when you call to schedule. If you go to an out-of-network provider who does not accept Medicare assignment, you may end up paying more.
The vaccine is given as an injection, usually in the upper arm. The first dose can be given at any time, and the second dose should be given two to six months later. Both doses count as preventive care under Part B, so both are covered at no cost to you.
What to do if you have Medicare Advantage or Part D coverage
Medicare Advantage plans (Part C) include Part B coverage, so Shingrix should be covered at no cost under your Advantage plan as well — but the rules can vary slightly by plan. Some Advantage plans may require you to use an in-network provider or may have different copay structures for vaccines. Call your plan's customer service number (on the back of your card) and ask whether Shingrix is covered and whether there are any copays.
If you have a standalone Part D prescription drug plan, Shingrix may be covered under that plan instead of Part B, depending on how your plan is structured. Part D plans often charge a copay for vaccines — this can range from a small amount to several dollars, depending on your plan. Again, call your plan to find out what you would pay.
If you have a Medigap (supplemental insurance) plan, Medigap does not cover the vaccine itself, but it may cover the copay or coinsurance you would owe under Original Medicare. Since Original Medicare covers Shingrix at no cost, Medigap would not add anything in this case.
Where to get the shingles vaccine
You can get Shingrix from several places: your primary care doctor's office, a pharmacy (including chain pharmacies like CVS and Walgreens), an urgent care clinic, or a health department clinic. All of these can administer the vaccine and bill Medicare directly if they are enrolled providers.
Pharmacies are often the fastest option because you can usually walk in without an appointment or call ahead to reserve a time. When you arrive, bring your Medicare card. The pharmacist will verify your coverage, give you the first dose, and schedule your second dose for two to six months later.
If you prefer to get the vaccine from your doctor, call your primary care office and ask for a preventive care appointment for the shingles vaccine. Let them know you have Medicare so they can confirm they will bill it as a covered preventive service.
The two-dose schedule and what happens between doses
Shingrix requires two doses to be fully protective against shingles. The CDC recommends spacing them two to six months apart. You do not have to wait the full six months — two months is the minimum, and many people get their second dose at two or three months.
Between the two doses, you are not yet fully protected, but you are building immunity. There is no harm in waiting longer than six months if you need to — the vaccine will still work, though the CDC prefers you stay within the two-to-six-month window. If you miss your second appointment, you can reschedule it whenever you are ready.
After you receive both doses, you are considered fully vaccinated against shingles. Protection lasts for years, and studies show it remains strong even as time passes. You do not need a booster dose.
Side effects and what to expect after the shot
Shingrix is safe, but it does cause side effects more often than some other vaccines. Common side effects include arm soreness, redness at the injection site, muscle aches, fatigue, and sometimes a low fever. These usually appear within a day or two and go away within two or three days.
Serious side effects are rare. If you have a severe allergic reaction (difficulty breathing, swelling of the face or throat), seek medical attention right away. If you have questions about whether Shingrix is safe for you because of other health conditions or medications, talk to your doctor before your appointment.
The side effects after the second dose are often similar to or slightly less intense than after the first dose. Having side effects does not mean the vaccine is not working — it usually means your immune system is responding.
If you had Zostavax in the past
Zostavax was the older shingles vaccine that was used for many years. It is no longer recommended because Shingrix is more effective. If you received Zostavax in the past, you can still get Shingrix.
The CDC recommends waiting at least 12 months after Zostavax before getting Shingrix. However, some doctors may recommend getting Shingrix sooner — for example, if you are at very high risk for shingles or if you do not remember exactly when you had Zostavax. Talk to your doctor about the right timing for you.
Medicare covers Shingrix even if you had Zostavax before, so cost is not a barrier to getting the newer vaccine.
Frequently Asked Questions
Do I have to be 50 to get the shingles vaccine under Medicare?
Yes, Medicare Part B covers Shingrix for people 50 and older. If you are under 50, you may still be able to get the vaccine, but Medicare would not cover it — you would pay out of pocket or check with your health insurance plan. Talk to your doctor if you think you need the vaccine before age 50.
What if I have already had shingles?
You can still get Shingrix even if you have had shingles before. In fact, the CDC recommends it, because you can get shingles more than once. If you had shingles recently, ask your doctor when it is safe to get vaccinated — usually at least a few weeks after the rash has healed.
Will Medicare cover the vaccine if I get it at a pharmacy instead of my doctor's office?
Yes, as long as the pharmacy is enrolled in Medicare and accepts Medicare payment. Most major chain pharmacies do. Bring your Medicare card, and the pharmacy will bill Medicare directly. You should pay nothing out of pocket.
What if my doctor says I should not get Shingrix because of a health condition?
Shingrix is safe for most people, but there are rare situations where a doctor might recommend waiting or not getting it. If your doctor advises against it, ask them to explain why and whether the situation might change in the future. You can always get a second opinion from another doctor if you want one.
Do I need to do anything special to prepare for the vaccine?
No special preparation is needed. You can eat and drink normally before your appointment. If you take blood thinners or have other medications, you do not need to stop them before getting Shingrix. Just bring your Medicare card and let the provider know about any severe allergies you have.