Medicare Part B covers Shingrix at no cost to you if you are 50 or older

Yes. Shingrix is the newer shingles vaccine, and Medicare Part B pays for the full cost of both doses with no copay, coinsurance, or deductible. You do not pay anything out of pocket for the vaccine itself. The only potential cost is the administration fee your doctor's office may charge, which varies by location and whether your doctor is in-network with your plan.

Medicare added Shingrix to its covered preventive services in January 2023. Before that date, the older vaccine Zostavax was covered, but it is no longer recommended and Medicare no longer covers it. If you received Zostavax in the past, you can still get Shingrix — there is no waiting period, though your doctor may recommend spacing between the two.

The vaccine requires two doses given two to six months apart. Both doses are covered at no cost. You will need to schedule each dose separately, as they are not given on the same day.

Key Takeaways

  • Medicare Part B covers both Shingrix doses with zero copay or deductible if you are 50 or older.
  • Your doctor's office may charge an administration fee to give the shot, which is separate from the vaccine cost and varies by provider.
  • You need two doses spaced two to six months apart; both are covered, but you schedule them as separate visits.
  • If you have a Medigap or Medicare Advantage plan, the vaccine is still free, but your plan may affect where you can get it and whether you pay an admin fee.

What Medicare Part B actually covers

Medicare Part B covers the Shingrix vaccine itself — the drug, the needle, the syringe. You pay nothing for those materials. What varies is the administration fee, which is the charge for the nurse or doctor to give you the shot. This fee is not set by Medicare; your provider sets it, and it typically ranges from $15 to $50 per dose, though some offices charge more.

If you go to a doctor's office that is in-network with your Medicare plan, the administration fee is usually lower or waived entirely. If you go out-of-network, you may pay more. Some pharmacies, including many CVS and Walgreens locations, also give Shingrix and may have different fee structures. Call ahead to ask what they charge for administration before you schedule.

The vaccine itself is always free under Medicare Part B. The administration fee is the only thing you might owe. Some beneficiaries pay nothing at all because their doctor's office absorbs the administration cost or because they have supplemental coverage that includes it.

How Medigap and Medicare Advantage plans affect your cost

If you have a Medigap plan (also called Medigap supplement insurance), Shingrix is still free under Medicare Part B, and your Medigap plan does not change that. However, your Medigap plan may cover the administration fee depending on which plan letter you have. Plans C, D, G, and M typically cover preventive care copays and coinsurance, which may include the administration fee. Check your plan documents or call your Medigap insurer to confirm.

If you have a Medicare Advantage plan (Part C), the vaccine is still free, but your plan controls which doctors and pharmacies you can use without paying extra. You must go to an in-network provider to get the free vaccine. If you go out-of-network, you may owe the full cost. Some Medicare Advantage plans also charge an administration fee even at in-network locations; check your plan's formulary or call customer service to confirm what you will pay.

Original Medicare (Part A and Part B with no supplement) has no network restrictions, so you can get Shingrix at any doctor or pharmacy that offers it.

Where to get Shingrix and what to bring

You can get Shingrix at your primary care doctor's office, a walk-in clinic, or a pharmacy. Common pharmacy chains including CVS, Walgreens, and Rite Aid offer it. Call ahead to confirm they have it in stock and to ask about their administration fee, since it varies by location even within the same chain.

Bring your Medicare card and photo ID. If you have a Medigap or Medicare Advantage plan, bring that card too. Tell the provider you are there for Shingrix and that it is covered by Medicare Part B. If you have already had the first dose, tell them the date so they can schedule the second dose correctly — it should be at least two months after the first, and no more than six months after.

You do not need a referral from your doctor to get Shingrix at a pharmacy. If you want your primary care doctor to give it, you may need to call and schedule an appointment, which can take longer than walking into a pharmacy.

Timing between the two doses

Shingrix requires two doses. The second dose must be given at least two months after the first dose and no more than six months after. If you miss the window and it has been longer than six months, you can still get the second dose — you do not have to start over. Just schedule it as soon as you remember.

Both doses are covered by Medicare at no cost. Some people schedule both doses at the same visit (for example, one in each arm), but most providers give them two to three months apart to let your immune system respond to the first dose before the second. Ask your provider what spacing they recommend.

Side effects from Shingrix are common but temporary — arm soreness, fatigue, and muscle aches are typical and usually fade within a day or two. These are not reasons to delay the second dose. If you had a serious allergic reaction to the first dose, tell your doctor before getting the second one.

If you are under 50 or have specific health conditions

Medicare Part B covers Shingrix for anyone 50 or older, regardless of whether you have ever had shingles. If you are under 50, Medicare does not cover it, though your regular health insurance (if you have it) may. Contact your health plan to ask.

If you are 50 or older and have a weakened immune system — for example, from HIV, cancer treatment, or an immunosuppressant medication — you are still covered by Medicare Part B for Shingrix. Tell your doctor about your condition so they can confirm the timing is safe. In some cases, your doctor may recommend waiting until your immune system is stronger, but that does not change Medicare's coverage.

If you are 50 or older and have already had shingles, you are still covered for Shingrix. There is no waiting period. Your doctor may recommend waiting a few months after shingles resolves before getting vaccinated, but Medicare covers it whenever you and your doctor decide to proceed.

Common mistakes and how to avoid them

The biggest mistake is assuming you have to pay because you saw a bill for the administration fee. The vaccine itself is free. The administration fee is separate and varies by provider. If you think the fee is too high, call other pharmacies or doctors' offices to compare before you schedule.

Another common mistake is going to an out-of-network provider if you have Medicare Advantage. Out-of-network providers may charge you the full cost of the vaccine and administration, even though it is free in-network. Check your plan's provider directory before you schedule, or call your plan to confirm the provider is in-network.

A third mistake is not scheduling the second dose before you leave the first appointment. Pharmacies and doctors' offices often book up, and if you wait weeks to schedule, you may end up outside the six-month window. Ask the provider to schedule both doses at the same time, even if they are months apart.

Finally, do not assume you need a referral or a doctor's order. You can walk into most pharmacies and ask for Shingrix without calling your doctor first. If you prefer to get it from your primary care doctor, call to schedule, but know that it may take longer than a pharmacy visit.

Frequently Asked Questions

Do I have to get Shingrix from my primary care doctor, or can I go to a pharmacy?

You can get it from either. Pharmacies often have more availability and shorter wait times. Your primary care doctor can also give it, but you may need to schedule an appointment. Both are covered by Medicare Part B at no cost for the vaccine itself.

What if I already got Zostavax years ago? Do I still need Shingrix?

Yes. Shingrix is more effective than Zostavax, and Medicare now recommends it for everyone 50 and older. There is no waiting period after Zostavax. You can get Shingrix whenever you and your doctor decide, and it is covered by Medicare Part B.

Will I have to pay the administration fee if I have Original Medicare?

You may, depending on where you get the vaccine. The administration fee is set by the provider, not by Medicare. Call ahead to ask what they charge. Some offices waive it; others charge $15 to $50 per dose. Your Medigap plan may cover it depending on which plan you have.

What happens if I wait longer than six months between doses?

You do not have to start over. You can still get the second dose whenever you are ready, and it will still be covered by Medicare. However, do not wait too long — the sooner you complete the series, the sooner you have full protection against shingles.

Can I get both doses on the same day?

Some providers will give both doses in one visit (usually one in each arm), but most space them two to three months apart. Ask your provider what they recommend. Either way, both doses are covered by Medicare at no cost.