Medicare Part B covers the shingles vaccine, but you may pay out of pocket depending on your plan

Medicare Part B covers two shingles vaccines: Shingrix (the newer two-dose vaccine) and Zostavax (the older one-dose vaccine, now rarely given). Part B pays for the vaccine itself after you meet your annual deductible. However, you will also pay a copay or coinsurance at the time of the shot, and the exact amount depends on where you get vaccinated and what your specific plan covers.

The vaccine is given in a doctor's office, clinic, or pharmacy. Medicare Part B typically covers 80 percent of the cost after your deductible is met, which means you pay 20 percent coinsurance. Some Medicare Advantage plans (Part C) cover shingles shots with no copay or a flat copay, but this varies by plan — you need to check your own plan's vaccine coverage.

Shingrix requires two shots given two to six months apart. Both doses are covered by Medicare Part B if you are 50 or older. The Centers for Disease Control and Prevention recommends Shingrix for all adults 50 and up, whether or not you have had shingles before.

Key Takeaways

  • Medicare Part B covers Shingrix (two doses) and Zostavax (one dose) for adults 50 and older, with no age limit.
  • You pay 20 percent coinsurance after your Part B deductible, unless you have a Medicare Advantage plan with different vaccine coverage.
  • Both doses of Shingrix are covered, spaced two to six months apart.
  • You can get the vaccine at your doctor's office, a clinic, or a pharmacy — anywhere that accepts Medicare Part B.
  • If you have had shingles before, you can still receive the vaccine, and Medicare will cover it.

How much you will pay out of pocket

Under Medicare Part B, you pay 20 percent coinsurance for the vaccine after you have met your annual deductible ($240 in 2024, though this amount changes yearly). The actual dollar amount you pay depends on what the provider charges for the vaccine and the administration fee. Shingrix typically costs between $150 and $200 per dose at most providers, so your 20 percent coinsurance would be roughly $30 to $40 per shot.

If you have a Medicare Advantage plan (Part C), your out-of-pocket cost may be different. Some plans cover vaccines with no copay at all. Others charge a flat copay — often $0 to $25 per shot — or they may still use coinsurance. You should call your plan's customer service number (on the back of your card) and ask specifically about shingles vaccine coverage before you schedule.

If you have not yet met your Part B deductible for the year, you will pay the full cost of the vaccine and administration until the deductible is satisfied. Once you have met it, you pay only the 20 percent coinsurance.

Where to get the shingles vaccine

You can receive Shingrix at your primary care doctor's office, an urgent care clinic, a pharmacy (such as CVS, Walgreens, or Rite Aid), or a community health center. All of these locations accept Medicare Part B. Call ahead to confirm they have the vaccine in stock and that they accept your specific Medicare plan, especially if you have a Medicare Advantage plan with network restrictions.

Pharmacies often have shorter wait times and more flexible scheduling than doctor's offices. If you use a pharmacy, bring your Medicare card and ask them to bill Medicare Part B directly. Most pharmacies are set up to do this automatically.

Some providers may ask you to pay the full cost upfront and then submit a claim to Medicare yourself, though this is less common. If this happens, ask for an itemized receipt showing the vaccine name, date, and cost, and keep it for your records when you file the claim.

What happens if you had Zostavax in the past

If you received Zostavax (the older one-dose shingles vaccine) more than a year ago, Medicare Part B will cover Shingrix. The CDC recommends that people who previously received Zostavax get Shingrix at least 12 months later for better protection. Medicare covers this revaccination.

If you received Zostavax less than 12 months ago, you can still get Shingrix, but you may want to wait until the 12-month mark to maximize the benefit. There is no harm in getting Shingrix sooner if you prefer, and Medicare will still cover it — the timing is a medical recommendation, not a coverage rule.

Medicare Advantage plans and shingles vaccine coverage

Medicare Advantage plans (Part C) are required by federal law to cover all vaccines recommended by the CDC for your age group, including Shingrix. However, the amount you pay out of pocket varies widely. Some plans cover vaccines with zero copay. Others charge a copay per dose (often $0 to $25). A few plans use coinsurance instead.

Your plan's coverage also depends on where you get the vaccine. If you go to an in-network provider, your copay or coinsurance applies. If you go out of network, you may pay more or the plan may not cover it at all. Check your plan documents or call the customer service number on your card to learn your plan's specific vaccine copay and any network restrictions.

Timing and scheduling your doses

Shingrix requires two doses. 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. Both doses are covered by Medicare Part B.

Schedule your first dose at a time when you can reasonably plan to return for the second dose. Some people schedule both appointments at once. Others prefer to schedule the second dose after the first shot, once they know their schedule. Either way, both doses are covered, so cost should not be a barrier to completing the series.

If you miss your second dose window, you can still get it later. There is no time limit on how long you can wait between doses, though the CDC recommends not waiting longer than six months for best protection.

Frequently Asked Questions

Do I have to be a certain age to get the shingles vaccine on Medicare?

No. Medicare covers Shingrix for all adults 50 and older. There is no upper age limit. Even if you are 85 or 95, Medicare Part B will cover the vaccine if you have not yet received it.

What if I had shingles already — will Medicare still cover the vaccine?

Yes. Medicare covers Shingrix even if you have had shingles in the past. The vaccine can prevent future episodes. You can get it any time after your shingles rash has healed, though most providers recommend waiting a few weeks.

Can I get the shingles vaccine at a pharmacy instead of my doctor's office?

Yes. Pharmacies at major chains like CVS, Walgreens, and Rite Aid accept Medicare Part B for shingles vaccines. Bring your Medicare card and let them know you want to bill Medicare. Pharmacies often have more convenient hours and shorter wait times than doctor's offices.

Will my Medicare Advantage plan cover Shingrix with a copay?

Most Medicare Advantage plans cover Shingrix, but the copay varies. Some charge nothing, others charge $10 to $25 per dose. Call your plan's customer service number to find out your specific copay before you schedule your shot.

What if I cannot afford the 20 percent coinsurance under Part B?

If cost is a barrier, ask your provider if they offer a payment plan or if there are any patient information programs. Some vaccine manufacturers offer discounts for people with financial hardship. Your local Area Agency on Aging can also point you toward resources that may help with vaccine costs.