Medicare covers the RSV vaccine at no cost to you if you are 60 or older

Yes, Medicare Part B covers the respiratory syncytial virus (RSV) vaccine for people aged 60 and up. You pay nothing out of pocket — no copay, coinsurance, or deductible — when you receive the shot at a participating provider. This coverage began in June 2023, making RSV vaccination one of the newer preventive services Medicare includes.

The vaccine protects against RSV, a respiratory virus that can cause serious illness in older adults, including pneumonia and bronchitis. Most people recover from RSV infection, but older adults and those with chronic conditions face higher risk of severe disease and hospitalization. A single dose of the vaccine provides protection, though your doctor may recommend a second dose depending on your health history and the specific vaccine used.

Key Takeaways

  • Medicare Part B covers RSV vaccination at no cost for people 60 and older, with no copay or deductible required.
  • You can receive the vaccine at your doctor's office, a pharmacy, or a clinic — any provider enrolled in Medicare.
  • Two RSV vaccines are currently available: Arexvy (made by GSK) and Abrysvo (made by Pfizer), and Medicare covers both.
  • Your doctor can advise whether you need one dose or two based on your age, health conditions, and previous RSV vaccination history.
  • You do not need to do anything special to set up this benefit — show your Medicare card when you schedule your appointment.

Where to get the RSV vaccine on Medicare

You can receive the RSV vaccine at any location that accepts Medicare, including your primary care doctor's office, urgent care clinics, pharmacies with vaccination services, and hospital outpatient departments. Call ahead to confirm the provider has the vaccine in stock and can administer it on the day you plan to visit.

Many pharmacy chains including CVS, Walgreens, and Rite Aid offer RSV vaccination. Some people find it convenient to schedule at a pharmacy during a routine errand, though availability varies by location. If you prefer your primary care doctor, call their office to ask whether they stock the vaccine and what appointment times are available.

Which RSV vaccines Medicare covers

Two RSV vaccines are currently approved for adults 60 and older: Arexvy (made by GlaxoSmithKline) and Abrysvo (made by Pfizer). Medicare covers both vaccines at no cost to you. The choice between them depends on what your provider has available and what your doctor recommends based on your health.

Both vaccines require a single injection, though in some cases your doctor may recommend a second dose. The timing and need for a second dose depends on factors like your age, whether you have chronic conditions, and whether you received an RSV vaccine previously. Your doctor can explain which vaccine and dosing schedule makes sense for you.

What happens during your appointment

When you call to schedule, tell the provider you have Medicare and want the RSV vaccine. Bring your Medicare card. The appointment itself is brief — the provider will ask about your medical history, give you the injection, and you may be asked to wait 15 minutes afterward to watch for any when ready reaction (which is rare).

Side effects are usually mild and temporary. Common ones include arm soreness, fatigue, muscle aches, and low-grade fever. These typically resolve within a day or two. Serious side effects are uncommon. If you have questions about whether the vaccine is right for you given your specific health conditions, ask your doctor before your appointment.

If you have both Medicare and other insurance

If you have Medicare and a supplemental insurance plan (Medigap) or a Medicare Advantage plan, Medicare remains the primary payer for the RSV vaccine. You still pay nothing out of pocket. Your supplemental or Advantage plan does not need to be involved — Medicare's coverage is complete.

If you have Medicaid in addition to Medicare, Medicaid may also cover the RSV vaccine depending on your state's rules. However, Medicare's coverage is sufficient on its own, so you do not need to coordinate between the two programs.

If you are under 60 or have questions about your coverage

RSV vaccination is not covered by Medicare for people under 60 unless your doctor determines you have a condition that puts you at very high risk for severe RSV disease. If you are under 60 and interested in the vaccine, talk with your doctor about whether it might be recommended for you based on your health.

If you are 60 or older and unsure whether you have already received an RSV vaccine, ask your doctor or check your vaccination records. Some people may have received the vaccine before Medicare's coverage began, and your doctor can advise whether you need another dose or whether one dose is sufficient for your protection.

Frequently Asked Questions

Do I need a referral from my doctor to get the RSV vaccine?

No. You can schedule directly at any provider that offers the vaccine — your doctor's office, a pharmacy, or a clinic. You do not need a referral. If you want your doctor's input on whether the vaccine is right for you, call their office first, but you can also ask the vaccine provider's staff when you arrive.

What if my provider says the vaccine is not in stock?

Call another provider in your area. Availability varies by location and changes over time. Pharmacies and clinics often have different stock levels, so trying a few options usually finds a provider with the vaccine available. You can also ask when they expect to receive more if you prefer to wait.

Will the RSV vaccine interfere with other vaccines I need?

You can receive the RSV vaccine at the same visit as other vaccines like the flu shot or pneumococcal vaccine. There is no waiting period required between RSV vaccination and other shots. Your doctor or vaccine provider can advise on the best timing if you have specific health concerns.

Is there a cost if I go to an out-of-network provider?

If you have Original Medicare (Part A and B), the vaccine is covered at no cost at any provider enrolled in Medicare, whether in-network or out-of-network. If you have a Medicare Advantage plan, check your plan's rules, as some Advantage plans have network restrictions. Call your plan before scheduling if you are unsure.

Can I get the RSV vaccine if I had RSV illness recently?

Yes, you can receive the vaccine even if you recently had RSV infection. Having had the illness does not prevent you from getting vaccinated. Your doctor can advise on timing if you are currently sick, but a recent RSV infection is not a reason to skip the vaccine.