Medicare Part B covers the shingles vaccine at no cost to you

Yes. Medicare Part B pays for both shingles vaccines — Shingrix and Zostavax — with no copay, coinsurance, or deductible. You do not pay anything out of pocket for the shot itself if you receive it at a Medicare-approved provider.

The vaccine is covered for anyone 50 and older with Medicare Part B, whether or not you have ever had shingles before. If you are 65 or older, you are in the age group most likely to develop shingles, and Medicare considers vaccination a preventive service.

The main thing to know is that where you get the shot matters. A pharmacy, doctor's office, or clinic that accepts Medicare will bill Medicare directly. If you go somewhere that does not accept Medicare assignment, you may be charged and have to file for reimbursement yourself — a slower and more complicated process.

Key Takeaways

  • Medicare Part B covers both Shingrix and Zostavax vaccines at no cost to you when given at a Medicare-approved provider.
  • Shingrix requires two shots given two to six months apart; Zostavax is a single shot, but Medicare now recommends Shingrix instead.
  • You need to go to a provider who accepts Medicare assignment to avoid being billed directly.
  • Call ahead to confirm the provider has the vaccine in stock and accepts Medicare, since not all pharmacies and clinics carry both.

The difference between Shingrix and Zostavax

Shingrix is the newer vaccine and is now the one Medicare recommends. It is more effective at preventing shingles and the long-term nerve pain that can follow — about 90 percent effective in people over 50. You receive two doses, with the second shot given two to six months after the first.

Zostavax is an older, single-dose vaccine that is still covered by Medicare but is less effective, especially in people over 65. If you received Zostavax in the past, you can still get Shingrix later. Most people who got Zostavax years ago should now get Shingrix for better protection.

Both vaccines are covered at no cost. The choice between them depends mainly on what your doctor recommends and what your provider has available. If you have a weakened immune system due to certain medications or conditions, ask your doctor which vaccine is safer for you.

Where to get the shingles vaccine

You can receive the shingles vaccine at your doctor's office, a community health center, a hospital outpatient clinic, or a pharmacy. Common pharmacy chains like CVS, Walgreens, and Rite Aid offer the vaccine and accept Medicare. Some urgent care clinics also provide it.

Before you go, call ahead to confirm three things: that the provider accepts Medicare, that they have the vaccine you want (Shingrix or Zostavax), and whether you need an appointment or can walk in. This saves a trip if they do not have stock or do not accept Medicare assignment.

If you use a pharmacy, bring your Medicare card. The pharmacist will verify your coverage and bill Medicare directly. You should not be asked to pay anything at the time of the shot.

What happens if you are charged

If a provider charges you for the vaccine or asks you to pay upfront, ask them to bill Medicare instead. Providers who accept Medicare assignment are required to bill Medicare and cannot charge you the full cost.

If you are charged and the provider refuses to bill Medicare, you can file a complaint with Medicare by calling 1-800-MEDICARE (1-800-633-4227). You can also ask the provider for an itemized receipt and submit it to Medicare yourself for reimbursement, though this takes longer.

To avoid this situation, confirm before your appointment that the provider accepts Medicare assignment. You can ask directly: "Do you accept Medicare assignment for the shingles vaccine?" If they say no, find another provider.

Timing between the two Shingrix doses

If you choose Shingrix, you will need two shots. The second dose should be given at least two months after the first, and no more than six months after. Most people schedule the second shot two to three months later.

If you miss your second dose and more than six months have passed, you do not need to start over. You can still get the second dose, and it will still protect you. There is no time limit on how long you can wait between doses.

Medicare covers both doses at no cost. Mark your calendar for the second appointment so you do not forget, or ask the provider to send you a reminder when it is time.

Who should not get the shingles vaccine

Most people 50 and older can safely receive the shingles vaccine. However, if you have a severe allergy to any ingredient in the vaccine, you should not get it. Tell your doctor or pharmacist about any allergies before the shot.

If you have a weakened immune system — from HIV, chemotherapy, or certain medications like those used for rheumatoid arthritis — talk to your doctor before getting vaccinated. Some people with immune system problems should not receive Shingrix, while others can receive it safely. Your doctor can advise you based on your specific situation.

If you are currently sick with a fever or serious infection, it is usually better to wait until you recover before getting the vaccine. A minor cold is not a reason to delay.

What to expect after the shot

Most people have no side effects or only mild ones. Common reactions include soreness or redness at the injection site, mild fever, muscle aches, or fatigue. These usually go away within two to three days.

Serious side effects are rare. If you have difficulty breathing, chest pain, or severe swelling after the shot, call 911 or go to an emergency room. If you have other concerning symptoms within a few days, contact your doctor.

It is normal to feel sore at the injection site for a day or two. You can use a cold compress or take over-the-counter pain relief if needed. The soreness does not mean the vaccine is not working.

Frequently Asked Questions

Do I need the shingles vaccine if I already had shingles?

Yes. You can get shingles more than once, though it is less common. The vaccine can help prevent it from happening again and reduce the severity if you do get it. Most doctors recommend waiting until at least one month after your shingles rash clears before getting vaccinated, but Medicare covers the vaccine either way.

What if I am on Medicare Advantage instead of Original Medicare?

Medicare Advantage plans must cover the same preventive services as Original Medicare Part B, including the shingles vaccine at no cost. However, you may need to use a provider in your plan's network. Check your plan documents or call the plan to find out where you can get the vaccine.

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

No. Pharmacists can give the shingles vaccine without a doctor's order in most states. You can walk into a pharmacy and ask for it. However, if you want your doctor to know you received it, you can ask the pharmacist to send a record to your doctor's office.

Can I get the shingles vaccine at the same time as other vaccines?

Yes. You can receive the shingles vaccine on the same day as the flu shot, pneumonia vaccine, or other vaccines. They can be given in different arms. There is no waiting period between different vaccines.

What if I cannot afford the vaccine even though Medicare covers it?

If Medicare covers it, you should not have to pay anything. If a provider is charging you, that is a billing error. Call 1-800-MEDICARE to report it and find a provider who accepts Medicare assignment. The vaccine itself is free under your Medicare benefit.