What Vaccines Medicare Covers and What You Pay

Medicare covers most vaccines at no cost to you, but which ones and how much you pay depends on which part of Medicare you have

Medicare Part B covers vaccines that prevent serious illness — including flu, pneumonia, shingles, and COVID-19 — with no copay or coinsurance when you go to an in-network provider. Medicare Part D (prescription drug coverage) covers some vaccines through the pharmacy benefit. If you have a Medicare Advantage plan (Part C), your coverage follows the same vaccines as Original Medicare, but you may have different copays or deductibles depending on your plan.

The catch is that not every vaccine is covered, and the ones that are covered may have age or health requirements. For example, Medicare covers the shingles vaccine only if you are 50 or older. Vaccines you get while in the hospital are covered under Part A. Vaccines you get at a pharmacy may be covered under Part D instead of Part B, which can change what you pay.

Key Takeaways

Medicare Part B covers flu, pneumonia, COVID-19, and shingles vaccines at no cost when you use an in-network provider.
Some vaccines are covered only if you meet age or health requirements — for example, the shingles vaccine is covered only at age 50 and older.
Vaccines given at a pharmacy may be billed to your Part D drug plan instead of Part B, which can result in a copay.
If you have a Medicare Advantage plan, the same vaccines are covered, but your out-of-pocket costs may differ based on your plan's rules.
You should ask your doctor or pharmacist which part of your Medicare will cover a vaccine before you receive it.

Which vaccines Medicare Part B covers

Medicare Part B covers five vaccines without cost to you: the flu shot, pneumococcal vaccine (pneumonia), shingles vaccine, COVID-19 vaccine, and RSV vaccine. Each has specific rules about age or health status.

The flu vaccine is covered once per year for everyone on Medicare, usually starting in the fall. The pneumococcal vaccine protects against bacterial pneumonia and is covered if you are 65 or older or have certain chronic conditions like diabetes or heart disease. The shingles vaccine (Shingrix) is covered if you are 50 or older and have not had it before. The COVID-19 vaccine is covered for all Medicare beneficiaries, including boosters. The RSV vaccine (Arexvy or Abrysvo) is covered if you are 60 or older, though your doctor may recommend it based on your health.

If you have had one of these vaccines before, Medicare may not cover a second dose unless your doctor says you need it for a medical reason. For example, if you had a pneumococcal vaccine more than a year ago and your health has changed, you may be covered for another one. Ask your doctor whether you need a repeat vaccine before you schedule it.

How much you pay when you get a vaccine

When you get a vaccine covered by Medicare Part B at a doctor's office or clinic, you pay nothing — no copay, no coinsurance, no deductible. This is true even if you have not met your Part B deductible for the year. The provider bills Medicare directly, and Medicare pays the full cost.

When you get a vaccine at a pharmacy, the cost depends on whether it is billed to Part B or Part D. If it is billed to Part B, you still pay nothing. If it is billed to Part D (your drug plan), you may have a copay, which varies by plan — typically $0 to $50 per vaccine. Before you get the vaccine at a pharmacy, ask the pharmacist which part of Medicare will be billed so you know what to expect.

If you have a Medicare Advantage plan, you pay according to your plan's rules. Some plans cover vaccines with no copay, while others charge a copay of $10 to $50. Check your plan documents or call your plan's customer service to find out what you will owe before you get the vaccine.

Vaccines Medicare does not cover

Medicare does not cover vaccines for travel, such as yellow fever, typhoid, or hepatitis A and B, unless you have a medical reason (for example, hepatitis B if you have end-stage renal disease). You will pay out of pocket for travel vaccines, though some travel clinics offer them at a lower cost than a doctor's office.

Medicare also does not cover the varicella vaccine (chickenpox) for adults, even if you have never had chickenpox. If you need this vaccine, you will pay the full cost yourself. Some vaccines for specific occupations — such as anthrax vaccine for military personnel — are not covered by Medicare.

If you are unsure whether a vaccine you need is covered, ask your doctor or pharmacist to check your coverage before you schedule it. They can call Medicare or your plan to confirm.

Getting a vaccine at a doctor's office versus a pharmacy

You can get most Medicare-covered vaccines at your doctor's office, a clinic, or a pharmacy. The vaccine itself is the same, but where you go affects how much you pay and how quickly you can get it.

At a doctor's office or clinic, the vaccine is almost always billed to Part B, so you pay nothing. You may need an appointment, which can take days or weeks to schedule. At a pharmacy (such as CVS, Walgreens, or your local grocery store pharmacy), you can often walk in without an appointment and get a vaccine the same day. However, the pharmacy may bill Part D instead of Part B, which means you could have a copay. Call the pharmacy ahead of time to ask which part of Medicare they bill for the vaccine you need.

If you have a Medicare Advantage plan, check whether your plan has preferred pharmacies or clinics where your copay is lower. Some plans cover vaccines at in-network pharmacies with no copay but charge a copay at out-of-network locations.

What to do if a provider charges you for a covered vaccine

If a doctor's office or pharmacy charges you for a vaccine that Medicare covers, you should not pay. Tell the provider that the vaccine is covered by Medicare and ask them to bill Medicare instead. If they still insist you pay, ask for an itemized receipt and contact Medicare to report the issue.

You can reach Medicare at 1-800-MEDICARE (1-800-633-4227) to report a provider who is charging for a covered vaccine. You can also file a complaint online through the Medicare website. Keep any receipts or bills you receive so you have proof of what happened.

If you already paid for a vaccine that should have been covered, you may be able to get a refund. Contact the provider first and ask them to submit the claim to Medicare. If they refuse, contact Medicare directly and ask about the refund process.

Keeping track of which vaccines you have had

Medicare does not automatically keep a record of vaccines you receive, so it is your responsibility to keep track. Ask your doctor or pharmacist for a written record each time you get a vaccine. Write down the name of the vaccine, the date, and where you received it.

You can also ask your doctor to add the vaccine to your medical record, which helps if you see multiple doctors or move to a new area. Some pharmacies keep records in their system, so if you always go to the same pharmacy, they may have a record on file.

Keeping your own record is important because some vaccines require a second dose or a booster after a certain amount of time. For example, the shingles vaccine (Shingrix) requires two doses given 2 to 6 months apart. If you do not know when you had your first dose, you may get a second dose too early or too late, which could mean you need to start over.

Frequently Asked Questions

Do I have to pay anything for a flu shot if I have Medicare?

No. Medicare Part B covers one flu shot per year at no cost to you when you get it at a doctor's office, clinic, or in-network pharmacy. You pay nothing — no copay, no deductible, no coinsurance.

Is the shingles vaccine covered if I am under 50?

No. Medicare covers the shingles vaccine (Shingrix) only if you are 50 or older. If you are younger than 50 and want the vaccine, you will pay out of pocket. Talk to your doctor about whether you need it and what it will cost.

What if my pharmacy wants to charge me a copay for a vaccine?

Ask the pharmacist which part of Medicare they are billing. If they are billing Part B, you should not have a copay — ask them to resubmit the claim. If they are billing Part D, a copay is normal and depends on your plan. Call your plan to find out what your copay should be.

Does Medicare cover vaccines I need for travel?

No, Medicare does not cover travel vaccines like yellow fever or typhoid unless you have a specific medical condition. You will pay out of pocket, though travel clinics often charge less than a doctor's office. Ask your doctor for a referral to a travel clinic in your area.

Can I get a second dose of a vaccine if I already had one?

It depends on the vaccine and how long ago you had it. Some vaccines require boosters after a certain time. Ask your doctor whether you need a second dose and whether Medicare will cover it. Your doctor can check your medical record and tell you what is covered.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.