Medicare Part B covers the shingles vaccine at no cost to you

Yes, Medicare Part B covers the shingles vaccine (Shingrix) with no copay, coinsurance, or deductible. You pay nothing out of pocket for the shots themselves. The vaccine requires two doses given two to six months apart, and Medicare covers both.

This coverage applies if you are enrolled in Medicare Part B, regardless of whether you have had shingles before. You do not need a referral from your doctor, though you can ask your primary care doctor where to get the vaccine.

The vaccine is given at pharmacies, doctor's offices, and some community health centers. Call ahead to confirm they have Shingrix in stock and that they accept your specific Medicare plan.

Key Takeaways

  • Medicare Part B pays the full cost of Shingrix with no out-of-pocket expense for the vaccine itself.
  • You need two doses of Shingrix, given two to six months apart, and both are covered.
  • You can get the vaccine at pharmacies, doctor's offices, and community health centers that accept Medicare.
  • If you have a Medigap or Medicare Advantage plan, your coverage may differ slightly, so check with your plan before your appointment.

Where to get the shingles vaccine

You have several options for where to receive Shingrix. Pharmacies like CVS, Walgreens, and Rite Aid administer the vaccine and accept Medicare. Your primary care doctor's office can also give it. Some community health centers and senior centers offer the vaccine as well.

Call ahead to the location you choose and confirm they have Shingrix available and that they accept your Medicare plan. Some locations may have limited hours or may need to order the vaccine if they do not have it in stock. Asking in advance prevents a wasted trip.

What happens at your appointment

When you arrive for your first dose, bring your Medicare card. The provider will ask about your medical history and any allergies, then give you the injection, usually in the upper arm. The appointment takes about 15 minutes.

You may experience mild side effects after the shot: arm soreness, redness at the injection site, muscle aches, or low fever. These typically fade within two to three days. Serious side effects are rare.

After your first dose, the provider will schedule your second dose. This must be given at least two months after the first dose, though six months apart is common. Both doses are needed for full protection against shingles.

Medicare Advantage and Medigap coverage

If you have a Medicare Advantage plan (Part C), your coverage for Shingrix is the same as Original Medicare — no cost to you. However, you must use a provider in your plan's network. Check your plan's provider directory or call the plan before scheduling.

If you have a Medigap policy, it does not cover the vaccine itself, but Original Medicare does, so your out-of-pocket cost remains zero. Medigap covers some of the costs that Original Medicare does not, but preventive vaccines are already fully covered by Medicare Part B.

Who should get the shingles vaccine

Medicare recommends Shingrix for all adults age 50 and older, whether or not you have had shingles before. If you had shingles in the past, you can still get the vaccine — there is no waiting period. The vaccine helps prevent shingles and reduces the severity if you do get it.

If you have a weakened immune system due to certain conditions or medications, talk to your doctor before getting the vaccine. Your doctor can advise whether Shingrix is right for you and when to schedule it.

If you had the older shingles vaccine

An older vaccine called Zostavax was used before Shingrix became available. If you received Zostavax in the past, you can still get Shingrix. Medicare recommends waiting at least 12 months after Zostavax before getting Shingrix, though your doctor may advise a different timeline based on your health.

Shingrix is more effective than Zostavax at preventing shingles and is now the standard vaccine. If you are unsure which vaccine you received, ask your doctor to check your medical records.

What to do if you have questions before your appointment

Call your doctor's office or the pharmacy where you plan to get the vaccine and ask whether they accept your specific Medicare plan. If you have a Medicare Advantage plan, confirm the provider is in your network. If you have questions about whether the vaccine is right for you, your doctor can discuss your individual health situation.

You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227) to confirm your coverage or find providers near you who offer Shingrix.

Frequently Asked Questions

Do I need both doses of Shingrix to be protected?

Yes, both doses are needed for full protection. One dose alone does not provide adequate protection against shingles. After your second dose, protection is high and lasts for years.

What if I had shingles years ago — can I still get the vaccine?

Yes. Having had shingles in the past does not disqualify you from getting Shingrix. The vaccine can still help prevent future episodes of shingles, which can occur even after you have had it once.

Will I have to pay anything out of pocket for the vaccine?

No. Medicare Part B covers the full cost of Shingrix with no copay or deductible. You pay nothing for the vaccine itself. Some providers may charge an administration fee, but this is rare and would be covered by Medicare as well.

Can I get the vaccine at any pharmacy, or does it have to be my pharmacy?

You can get it at any pharmacy or provider that accepts Medicare and has Shingrix in stock. You do not have to use a specific pharmacy. If you have a Medicare Advantage plan, the provider must be in your plan's network.

What if I am allergic to any ingredients in Shingrix?

Tell your doctor or pharmacist about any allergies before your appointment. Shingrix contains specific ingredients, and your doctor can review them with you. Serious allergies to the vaccine are uncommon, but your doctor can advise whether it is safe for you.