Medicare Part B covers the shingles vaccine at no cost to you
Medicare Part B covers the recombinant zoster vaccine (Shingrix) with no copay, coinsurance, or deductible. You pay nothing out of pocket. The vaccine is given as two shots, two to six months apart, and both doses are covered. This applies whether you get the shots at your doctor's office, a pharmacy, or a health clinic.
The coverage is the same for all Medicare beneficiaries age 50 and older. You do not need to meet any special conditions or have a prior shingles infection to receive it. If you are enrolled in Original Medicare (Part A and Part B), you are covered. If you are in a Medicare Advantage plan, coverage is the same, though you may need to use an in-network provider.
Key Takeaways
- Medicare Part B covers both doses of Shingrix with zero cost to you, including no copay or deductible.
- You are covered starting at age 50, even if you have never had shingles or received an older shingles vaccine before.
- Both Original Medicare and Medicare Advantage plans cover the vaccine, though Advantage plans may require in-network providers.
- You do not need a referral or prior authorization from Medicare to receive the vaccine.
- The two doses must be given two to six months apart, and both are covered in full.
Who is covered and when you can get the vaccine
You are covered if you are 50 or older and enrolled in Medicare Part B. Age 50 is the threshold — Medicare does not cover the shingles vaccine for anyone under 50, even if they are on Medicare for disability reasons. If you are 50 or older and have Part B, you can receive the vaccine regardless of whether you have ever had shingles, chickenpox, or the older shingles vaccine (Zostavax).
You do not need to wait for a specific date or season. You can receive the first dose at any time during the year. The second dose follows two to six months later. There is no enrollment period or special sign-up process — coverage is automatic if you have Part B.
Where to get the vaccine and what to bring
You can receive Shingrix at your primary care doctor's office, a pharmacy (such as CVS, Walgreens, or Rite Aid), a health department clinic, or other healthcare facilities that stock the vaccine. Call ahead to confirm they have Shingrix in stock, because some locations may have temporary shortages.
Bring your Medicare card. If you are in a Medicare Advantage plan, also bring your plan card. The provider will verify your coverage before administering the vaccine. You do not need a referral from your doctor, though you can ask your doctor for a recommendation or to schedule the vaccine during a routine visit.
What happens if you received Zostavax before
If you previously received Zostavax (the older shingles vaccine), you can still receive Shingrix. Medicare covers both doses of Shingrix even if you had Zostavax in the past. There is no waiting period — you can start Shingrix when ready after Zostavax, though most doctors recommend waiting at least 12 months to allow your immune system to settle.
You do not need to tell Medicare or your doctor that you had Zostavax. straightforward schedule the Shingrix doses as you would for anyone else. The vaccine provider will document both vaccines in your medical record.
Medicare Advantage plans and in-network requirements
If you are enrolled in a Medicare Advantage plan, Shingrix is covered with the same zero cost to you. However, you must use a provider in your plan's network to receive the full benefit. Using an out-of-network provider may result in a higher cost or no coverage at all.
Check your plan's provider directory or call the plan directly to find in-network locations where you can receive the vaccine. Many Advantage plans contract with major pharmacy chains and primary care offices, so you often have multiple options. If your preferred doctor or pharmacy is out of network, ask your plan if they will make an exception or cover the vaccine at an in-network location instead.
Timing between the two doses
The two doses of Shingrix must be given at least two months apart and no more than six months apart. If you wait longer than six months between doses, you will need to restart the series — meaning you will receive two new doses starting from the first one. Both doses are covered by Medicare, so restarting does not cost you anything, but it delays your protection.
Mark your calendar for the second dose appointment when you receive the first one. If you miss the appointment, contact the provider as soon as you remember to reschedule. Most providers will hold your appointment slot for several weeks before canceling it.
Side effects and what to expect
Common side effects include arm soreness, redness at the injection site, muscle aches, fatigue, and mild fever. These usually appear within one to two days and resolve within two to three days. Serious side effects are rare. You do not need to do anything special before or after the vaccine — you can resume normal activities when ready.
If you have a severe allergic reaction (difficulty breathing, swelling of the face or throat), seek emergency care. If you have other concerns after the vaccine, contact your doctor. Medicare covers any follow-up care related to the vaccine through Part B.
Frequently Asked Questions
Do I have to pay anything out of pocket for Shingrix?
No. Medicare Part B covers both doses with zero copay, coinsurance, or deductible. You pay nothing at the time of the vaccine or afterward. This applies to all Medicare beneficiaries age 50 and older.
What if my pharmacy says they need prior authorization?
Shingrix does not require prior authorization from Medicare. If a pharmacy or doctor's office tells you they need authorization, ask them to contact Medicare directly or check the Medicare coverage rules. You can also call Medicare at 1-800-MEDICARE to confirm coverage before your appointment.
Can I get the vaccine if I am still working and have employer health insurance?
Yes. If you are 65 or older, Medicare is your primary insurance and covers the vaccine. If you are under 65 and on Medicare for disability, your employer plan may be primary, but Medicare Part B will still cover Shingrix once your employer plan has paid its share.
What if I had shingles in the past — am I still covered?
Yes. You can receive Shingrix even if you have had shingles before. Medicare covers the vaccine for anyone 50 or older with Part B, regardless of shingles history. The vaccine helps prevent shingles from occurring again.
Do I need to schedule both doses at the same time?
No. You can schedule the first dose whenever you are ready. When you receive the first dose, ask the provider to schedule your second dose two to six months later. If you prefer to schedule the second dose on your own, you can do that as well — just make sure it is within the two to six month window.