Medicare covers the RSV vaccine at no cost to you if you are 60 or older

Medicare Part B covers two RSV vaccines — Arexvy (made by GSK) and Abrysvo (made by Pfizer) — with no copay, coinsurance, or deductible. Both vaccines were approved by the FDA in 2023 and became covered by Medicare in 2024. You receive a single dose, given as a shot in the upper arm.

The vaccine protects against respiratory syncytial virus, a common respiratory illness that can cause serious complications in older adults, including pneumonia and hospitalization. If you are 60 or older, you are may be able to access for the vaccine regardless of your health history. You do not need to have had RSV before or to be at high risk — Medicare covers it for all beneficiaries in this age group.

Coverage is the same whether you have Original Medicare (Part A and Part B) or Medicare Advantage. If you have Advantage, your plan must cover the vaccine at no cost because federal law requires all Medicare plans to cover all vaccines approved for Medicare beneficiaries.

Key Takeaways

  • Medicare Part B covers both Arexvy and Abrysvo vaccines at no cost if you are 60 or older, with no copay or deductible.
  • You receive one dose of either vaccine as a shot, and coverage is the same under Original Medicare and Medicare Advantage plans.
  • You can get the RSV vaccine at your doctor's office, a pharmacy, or a hospital outpatient clinic — anywhere that administers vaccines and accepts Medicare.
  • If you have already paid out of pocket for an RSV vaccine before Medicare coverage began, you may be able to request a refund from your provider.

Where to get the RSV vaccine

You can receive the RSV vaccine at your primary care doctor's office, a retail pharmacy (such as CVS, Walgreens, or Rite Aid), or a hospital outpatient clinic. Call ahead to confirm the location has the vaccine in stock and that it accepts your Medicare plan. Most pharmacies and doctor's offices now carry at least one of the two vaccines.

When you arrive, bring your Medicare card. The provider will bill Medicare directly, and you will pay nothing at the time of service. If a provider asks you to pay upfront, tell them Medicare covers the vaccine at no cost and ask them to bill your plan instead.

What happens if you already paid for the vaccine

If you received an RSV vaccine before Medicare coverage began and paid out of pocket, you may be able to request a refund. Contact the provider or pharmacy where you received the vaccine and explain that Medicare now covers it. Some providers will issue a refund; others may not, depending on their refund policy and how long ago you paid.

Keep your receipt and any paperwork from the vaccination. If the provider declines to refund you, you can contact Medicare at 1-800-MEDICARE to ask whether you have other options, though refunds are not may provide.

Choosing between Arexvy and Abrysvo

Both vaccines are covered at no cost, so your choice between them depends on what your doctor recommends and which one is available at your preferred location. The two vaccines work similarly — each prevents RSV infection by teaching your immune system to recognize the virus. Clinical trials showed both vaccines reduce the risk of severe RSV illness in older adults.

Talk with your doctor about which vaccine is right for you, especially if you have a history of severe allergies or other health conditions. Your doctor can also tell you whether you should wait a certain amount of time if you recently received another vaccine, though most vaccines can be given at the same visit.

RSV vaccination if you have Medicare Advantage

All Medicare Advantage plans must cover the RSV vaccine at no cost because federal law requires them to cover all Medicare-covered vaccines. However, you should confirm with your specific plan that both Arexvy and Abrysvo are included, since plans sometimes have different networks of pharmacies and doctors.

Call the customer service number on your Advantage plan card and ask whether the RSV vaccine is covered and where you can get it. If your plan has a preferred pharmacy network, using an in-network location will may support smooth billing. If you go to an out-of-network provider, your plan must still cover the vaccine, but you may face delays in processing.

What to do if you cannot find the vaccine

Vaccine supply varies by location and changes over time. If your doctor's office or local pharmacy does not have the RSV vaccine in stock, ask when they expect to receive it. You can also call other pharmacies or clinics in your area to find where it is available.

Your doctor can also help you locate the vaccine. Some health departments and senior centers offer vaccines as well. If you live in a rural area where the vaccine is hard to find, ask your doctor whether it is worth traveling to a nearby city or waiting for supply to arrive locally.

Frequently Asked Questions

Do I need a doctor's order to get the RSV vaccine?

No. You can walk into most pharmacies and ask for the RSV vaccine without a doctor's order. However, talking with your doctor first is a good idea, especially if you take other medications or have health conditions that might affect which vaccine is best for you.

Can I get the RSV vaccine if I have Original Medicare but no Part B?

No. The RSV vaccine is covered under Part B. If you have only Part A, you will need to enroll in Part B to have the vaccine covered. You can enroll during the General Enrollment Period (January 1 to March 31 each year) or during a Special Enrollment Period if you may have access to.

What if I am 59 and turning 60 soon — can I get the vaccine now?

Medicare covers the vaccine only for people 60 and older. If you are not yet 60, you would need to pay out of pocket. Once you turn 60, Medicare will cover it. Ask your doctor whether waiting a few months is safe or whether you should pay now.

Will getting the RSV vaccine affect other vaccines I need?

Most vaccines can be given at the same visit. However, if you recently received another vaccine, ask your doctor or pharmacist whether you should wait. The timing depends on which vaccines you have had and when. Your provider can tell you the right schedule.

What are the side effects of the RSV vaccine?

Common side effects are mild and temporary — arm soreness, fatigue, muscle aches, or low fever. Serious side effects are rare. Talk with your doctor about what to expect and when to call if you have concerns after vaccination.