Medicare's Coverage of Shingles Shots

Medicare Part B covers the shingles vaccine (Shingrix) at no cost to you if you are 50 or older. You pay nothing out of pocket — no copay, no coinsurance, no deductible. The vaccine requires two shots given two to six months apart, and both are covered. You get the shots at a pharmacy, doctor's office, or health clinic that accepts Medicare.

This coverage applies whether you have Original Medicare (Part A and B) or Medicare Advantage (Part C). If you have Advantage, your plan must cover the vaccine at no cost because federal law requires it. The catch is that some Advantage plans may steer you to specific pharmacies or providers, so check your plan documents or call the number on your card before you schedule.

Key Takeaways

  • Medicare Part B covers both doses of Shingrix at no cost for people 50 and older, with no copay or deductible.
  • You can get the vaccine at any Medicare-enrolled pharmacy or doctor's office, but Medicare Advantage plans may require you to use in-network providers.
  • The two doses must be given two to six months apart; Medicare covers both even if you turn 50 between the first and second shot.
  • If you had the older shingles vaccine (Zostavax) in the past, you can still get Shingrix — there is no waiting period required.

Where to Get Your Shingles Vaccine

You can receive Shingrix at any pharmacy or medical office that participates in Medicare. This includes chain pharmacies (CVS, Walgreens, Rite Aid), independent pharmacies, your primary care doctor's office, urgent care clinics, and some health departments. Call ahead to confirm they have the vaccine in stock and that they accept your specific Medicare plan.

If you have Medicare Advantage, your plan may require you to use in-network providers to receive the vaccine at no cost. Using an out-of-network provider could result in a bill. Check your plan's provider directory or call customer service to find participating locations near you. Original Medicare has no network restrictions — you can go to any Medicare-enrolled provider.

The Two-Dose Schedule and Timing

Shingrix is given as two separate injections. The second dose should be given two to six months after the first. Both doses are covered by Medicare at no cost. If you space them further apart than six months, Medicare still covers the second dose — there is no penalty for a longer gap, though your protection may be delayed.

If you turn 50 between your first and second dose, both shots are still covered. You do not need to wait until you are 50 to start the series; you can begin at 49 and complete it after you turn 50. Medicare will cover whichever dose you receive on or after your 50th birthday.

If You Received Zostavax Previously

Zostavax was the older shingles vaccine that Medicare covered before Shingrix became available. If you received Zostavax in the past, you are still may be able to access for Shingrix. There is no required waiting period between Zostavax and Shingrix — you can get Shingrix when ready, though most doctors recommend waiting at least 12 months to allow your immune system to respond fully to each vaccine.

If you received Zostavax more than once, you can still get Shingrix. Medicare does not limit you based on prior shingles vaccination history. The protection from Zostavax fades over time, so Shingrix is recommended even if you had the older vaccine years ago.

Medicare Advantage and Original Medicare Differences

Both Original Medicare and Medicare Advantage must cover Shingrix at no cost, but the experience differs slightly. With Original Medicare, you go to any Medicare-enrolled provider and show your Medicare card. With Advantage, you must use in-network providers unless your plan has an out-of-network benefit, and you show your Advantage card instead.

Some Advantage plans may require prior authorization before you get the vaccine, meaning your doctor or pharmacist must contact the plan first to confirm coverage. This usually takes one business day. If your plan requires it, the provider will handle the request — you do not need to do it yourself. Ask when you call to schedule whether authorization is needed.

What Happens If You Have Not Reached 50 Yet

If you are under 50, Medicare does not cover Shingrix. You would need to pay out of pocket or check whether your employer health plan or other insurance covers it. The cost without insurance is typically $150 to $200 per dose, so $300 to $400 for the full series. Some state health departments or community health centers offer vaccines on a sliding fee scale based on income.

Once you turn 50, you become may be able to access for the free Medicare coverage. You do not need to wait for an annual enrollment period or any other trigger — coverage begins on your 50th birthday. You can schedule your first dose anytime after that date.

Frequently Asked Questions

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

No. Pharmacists can administer Shingrix without a doctor's order in most states. You can walk into a pharmacy, ask for the vaccine, and get it the same day if they have it in stock. Some pharmacies may ask for your medical history to screen for contraindications, but you do not need a prescription or prior visit to a doctor.

Will I have to pay anything out of pocket for Shingrix?

No. Medicare Part B covers the full cost of both doses at no copay, coinsurance, or deductible. You should not receive a bill. If a provider bills you, contact Medicare or your Advantage plan to report it.

What if I had shingles in the past — can I still get the vaccine?

Yes. Having had shingles does not disqualify you from vaccination. In fact, the vaccine is recommended even for people with a history of shingles, because you can get shingles more than once. You can get Shingrix anytime after you recover from an active shingles infection.

Can I get both doses at the same visit?

No. The two doses must be given at separate visits, at least two months apart. This spacing allows your immune system to build a stronger response. You cannot receive both shots on the same day.

What if my pharmacy says they do not have Shingrix in stock?

Ask when they expect to receive it, or call other nearby pharmacies to find one that has it available. Shingrix can be in short supply at certain times. You can also ask your doctor's office whether they stock it. There is no rush — you can get the vaccine whenever it becomes available at a location convenient to you.