Medicare Part B covers the RSV vaccine for adults 60 and older at no cost to you

Medicare Part B pays for the RSV vaccine (respiratory syncytial virus) if you are 60 or older. You do not pay a copay, coinsurance, or deductible — the vaccine itself is covered in full. This applies whether you get the shot at a doctor's office, hospital outpatient clinic, or pharmacy that participates with Medicare.

The vaccine became available in 2023 and was added to Medicare's covered preventive services in 2024. It is a single-dose injection, usually given in the upper arm. Your doctor or pharmacist can administer it during a regular visit.

If you are under 60, Medicare does not cover the RSV vaccine. Some private insurance plans may cover it for younger adults at higher risk, but that depends on your specific plan. Check with your insurer directly if you fall into this group.

Key Takeaways

  • Medicare Part B covers the RSV vaccine at no cost if you are 60 or older, with no deductible or copay required.
  • The vaccine is a single injection given by your doctor or pharmacist and protects against respiratory syncytial virus, which causes serious illness in older adults.
  • You can receive the vaccine at any Medicare-participating provider, including doctor's offices, hospitals, and pharmacies.
  • If you are under 60, Medicare does not cover the vaccine, though some private insurance plans may offer coverage depending on your risk factors.

Where to get the RSV vaccine on Medicare

You can get the RSV vaccine at your primary care doctor's office, an urgent care clinic, a hospital outpatient department, or a pharmacy such as CVS, Walgreens, or your local grocery store pharmacy. Call ahead to confirm the provider has the vaccine in stock and accepts Medicare.

Many pharmacies now offer the RSV vaccine without an appointment, though some require you to schedule in advance. If you use a pharmacy, bring your Medicare card. The pharmacist will bill Medicare directly, and you will owe nothing at the point of service.

If you see your primary care doctor, ask during your next visit whether they have the vaccine available. Some practices order it on demand, so there may be a short wait. Hospital outpatient clinics typically have it on hand if you are already a patient there.

What happens after you get the vaccine

The RSV vaccine is a single dose — you do not need a booster shot. After you receive it, your arm may be sore for a day or two, and some people experience mild fatigue or low-grade fever. These side effects are normal and usually fade within 48 hours.

Serious side effects are rare. If you experience severe allergic reaction, difficulty breathing, or chest pain after the vaccine, call 911 or go to the nearest emergency room. Report any side effect to your doctor, and you can also report it to the Vaccine Adverse Event Reporting System (VAERS) at vaers.hhs.gov.

Once you have received the vaccine, you are protected against RSV. The duration of protection is still being studied, but current data suggests protection lasts at least through one RSV season. Your doctor will let you know if a second dose becomes recommended in the future.

Who should and should not get the RSV vaccine

The RSV vaccine is recommended for all adults 60 and older. It is especially important if you have chronic lung disease, heart disease, diabetes, or a weakened immune system — conditions that put you at higher risk of severe RSV illness. If you live in a nursing home or assisted living facility, the vaccine is strongly recommended.

You should not get the RSV vaccine if you have had a severe allergic reaction to any ingredient in the vaccine. If you are unsure whether you have a relevant allergy, tell your doctor before the shot. Pregnancy is not a reason to avoid the vaccine, though most pregnant women have not yet received it because it was approved recently.

If you are acutely ill with fever or other symptoms, your doctor may ask you to wait until you recover before getting the vaccine. This is a temporary delay, not a permanent reason to skip it.

What RSV is and why older adults need protection

Respiratory syncytial virus (RSV) is a common virus that causes cold-like symptoms in most people — runny nose, cough, sore throat, and sometimes fever. In older adults and people with chronic illness, RSV can cause severe pneumonia, hospitalization, and death.

RSV spreads through respiratory droplets, the same way cold and flu viruses spread. It is most common in fall and winter, though it can occur year-round. There is no treatment for RSV itself — doctors manage symptoms while your immune system fights the infection. Prevention through vaccination is the most effective way to avoid it.

Before the RSV vaccine became available, thousands of older Americans were hospitalized each year with RSV pneumonia. The vaccine reduces that risk significantly. Studies show it prevents about 80 to 90 percent of severe RSV disease in older adults.

If you have other insurance in addition to Medicare

If you have a Medigap or Medicare Advantage plan in addition to Original Medicare Part B, your coverage for the RSV vaccine does not change. Medicare Part B is the primary payer, and the vaccine remains free to you. Your supplemental plan does not charge you anything extra.

If you have only a Medicare Advantage plan (sometimes called Part C) and no Original Medicare Part B, your coverage depends on your specific plan. Most Medicare Advantage plans cover the RSV vaccine at no cost because they must cover everything Original Medicare covers. Call your plan's customer service number to confirm before you get the vaccine.

If you have Medicaid in addition to Medicare, Medicaid also covers the RSV vaccine for adults 60 and older. You do not need to choose between them — Medicare will pay first, and Medicaid will not charge you anything.

Frequently Asked Questions

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

No. Pharmacists can administer the RSV vaccine without a doctor's order in most states. You can walk into a pharmacy, show your Medicare card, and receive the vaccine on the spot. If the pharmacy asks for a doctor's order, you can ask to speak with the pharmacist directly — many pharmacies have standing orders that allow pharmacists to give the vaccine without calling your doctor first.

Will the RSV vaccine interfere with other vaccines I need?

The RSV vaccine can be given at the same time as flu and pneumococcal vaccines, or at different times. There is no waiting period between them. If you are due for your annual flu shot and your pneumonia vaccine, you can get all three on the same day. Tell your provider which vaccines you have already received so they do not repeat any.

What if I got RSV before the vaccine was available — do I still need it?

Yes. Having RSV once does not provide lasting immunity, and you can get it again. The vaccine is still recommended even if you have had RSV in the past. Your doctor can discuss your individual situation, but most older adults benefit from the vaccine regardless of prior infection.

Is the RSV vaccine covered if I get it at a hospital instead of a doctor's office?

Yes. Medicare covers the RSV vaccine at any Medicare-participating provider, including hospital outpatient departments. You will not pay anything out of pocket. If the hospital tries to charge you, contact Medicare at 1-800-MEDICARE to report it.

Can I get the RSV vaccine if I am on blood thinners or have a bleeding disorder?

Yes, but tell your provider before the shot. The RSV vaccine is given as an injection, and if you take blood thinners like warfarin or apixaban, your provider may explore extra pressure after the injection to prevent bleeding. This does not prevent you from getting the vaccine — it just requires a small adjustment in how it is given.