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

Yes, Medicare Part B pays for the shingles vaccine (Shingrix) with no copay, coinsurance, or deductible. You receive two doses, given two to six months apart. Both doses are covered as a preventive service, which means you pay nothing out of pocket if you see a doctor or nurse who accepts Medicare.

The shingles vaccine is recommended for all adults age 50 and older, whether or not you have had shingles before. Medicare began covering Shingrix in 2018, replacing an older vaccine called Zostavax that required a copay.

You do not need to be sick or have any symptoms to get the vaccine. You can receive it during a regular doctor visit or at a pharmacy that administers vaccines and accepts Medicare.

Key Takeaways

  • Medicare Part B covers both doses of the Shingrix vaccine at no cost to you when given by a Medicare-approved provider.
  • You need two doses, spaced two to six months apart, to be fully protected against shingles.
  • The vaccine is recommended for all Medicare beneficiaries age 50 and older, even if you have had shingles before.
  • You can get the vaccine at your doctor's office, a clinic, or a pharmacy that accepts Medicare.

Where you can get the shingles vaccine

You have several options for where to receive the Shingrix vaccine. Your primary care doctor can give it to you during an office visit. Many pharmacies, including those at grocery stores and drugstores, also administer the vaccine and accept Medicare. Federally may have access to health centers and senior centers sometimes offer it as well.

Before you go, call ahead to confirm that the location accepts Medicare and has the vaccine in stock. Ask whether you need an appointment or can walk in. Some pharmacies require an appointment for vaccines, while others accept walk-ins.

If you use a Medicare Advantage plan (Part C) instead of Original Medicare, check your plan's website or call the plan to find out which providers and pharmacies are in your network. You will still pay nothing for the vaccine, but you must use an in-network provider to avoid extra costs.

What happens if you have had shingles before

You can still receive the Shingrix vaccine even if you have had shingles in the past. In fact, the vaccine is recommended for people who have had shingles, because shingles can occur more than once. Getting vaccinated after shingles reduces the chance of it happening again.

If you had shingles recently, ask your doctor when it is safe to get vaccinated. Most doctors recommend waiting until the shingles rash has healed completely, which can take several weeks. There is no minimum time you must wait, but your doctor can advise based on your situation.

What to bring and what to expect

Bring your Medicare card when you go for the vaccine. The provider will check your coverage and confirm you have not already received both doses of Shingrix. You may also be asked about any allergies or medical conditions that could affect whether the vaccine is right for you.

The vaccine itself is an injection, usually given in the upper arm. The first dose takes just a few minutes. You will receive the second dose at your next appointment, which should be scheduled two to six months later. Most people experience mild side effects like arm soreness, fatigue, or muscle aches for a day or two after the shot. Serious side effects are rare.

After you receive each dose, the provider should record it in your medical record and in the national vaccine registry. This helps may support you do not accidentally receive a third dose and helps your doctors know your vaccination status.

If you have a Medicare Advantage plan

Medicare Advantage plans (also called Part C) must cover the shingles vaccine at no cost, just as Original Medicare does. However, you must use a provider or pharmacy that is in your plan's network to get the full benefit.

Check your plan's website or call the customer service number on your insurance card to find in-network locations near you. If you go to an out-of-network provider, you may be charged a copay or coinsurance, even though the vaccine itself is preventive.

Some Medicare Advantage plans offer the vaccine at their own clinics or partner pharmacies. Others direct you to your primary care doctor. The rules vary by plan, so it is worth checking before you schedule your appointment.

If you have not yet turned 50

Medicare does not cover the shingles vaccine for people under age 50, even if they are already on Medicare for another reason (such as disability). If you are under 50 and want the vaccine, you would need to pay out of pocket or check whether your private insurance covers it.

Once you turn 50, you become may be able to access for the vaccine under Medicare Part B. You do not have to wait for your birthday or any other event — you can schedule it as soon as you turn 50.

What to ask your doctor

Before you get the shingles vaccine, it is reasonable to ask your doctor a few questions. Ask whether Shingrix is right for you based on your health history. Ask when you should come back for the second dose. Ask what side effects to expect and when to call if something concerns you.

If you have had shingles before, ask your doctor how long to wait after the rash heals before getting vaccinated. If you take medications that affect your immune system, ask whether the vaccine will work as well for you or whether you should wait.

If you are unsure whether your provider accepts Medicare, ask the office staff directly. Do not assume based on whether they accept other insurance.

Frequently Asked Questions

Do I need the shingles vaccine if I have never had shingles?

Yes. The vaccine is recommended for all adults age 50 and older, whether or not you have had shingles. Most people who get shingles have no warning and no prior symptoms. The vaccine significantly reduces your risk of developing shingles and reduces the severity if you do get it.

What if I already received the older Zostavax vaccine?

If you received Zostavax (the older shingles vaccine) before 2018, you should still get Shingrix. Medicare recommends that people who previously received Zostavax get the newer vaccine for better protection. There is no required waiting period between the two vaccines, though your doctor may recommend spacing them out.

Can I get the shingles vaccine if I am taking other medications?

Most medications do not prevent you from getting Shingrix. However, if you take medications that weaken your immune system (such as steroids or immunosuppressants), tell your doctor before the vaccine. Your doctor can advise whether to delay the vaccine or whether it is safe to receive it now.

Will I have to pay anything for the vaccine?

No. Medicare Part B covers both doses of Shingrix with no copay, coinsurance, or deductible when you use a Medicare-approved provider. If you use a Medicare Advantage plan, you also pay nothing as long as you use an in-network provider.

What if my pharmacy says Medicare will not cover it?

Call Medicare directly at 1-800-MEDICARE to confirm your coverage. Occasionally a pharmacy's billing system has outdated information. Medicare can tell you whether the vaccine is covered under your specific plan and help resolve any billing issues.