Medicare covers the shingles vaccine at no cost to you

Medicare Part B covers the shingles vaccine (Shingrix) with no copay, coinsurance, or deductible if you are 50 or older. You get two doses, given two to six months apart. The vaccine prevents shingles, a painful rash caused by the same virus that causes chickenpox.

You do not have to pay anything out of pocket for the vaccine itself when you receive it at a Medicare-enrolled provider. This is true whether you get the shot at your doctor's office, a pharmacy, or a health clinic.

If you have a Medigap or Medicare Advantage plan in addition to Original Medicare, your coverage remains the same — you still pay nothing for the vaccine.

Key Takeaways

  • Medicare Part B covers Shingrix (the shingles vaccine) at no cost for people 50 and older.
  • You need two doses given two to six months apart, and neither dose costs you anything.
  • The vaccine is covered at any Medicare-enrolled provider, including doctor's offices and pharmacies.
  • You do not need a referral or prior authorization from Medicare to receive the vaccine.
  • If you had the older shingles vaccine (Zostavax) in the past, you can still receive Shingrix.

Where you can get the shingles vaccine

You can receive the shingles vaccine at any provider that accepts Medicare, including your primary care doctor, a dermatologist, a pharmacy with a vaccination clinic (such as CVS or Walgreens), or a community health center. Call ahead to confirm they have Shingrix in stock and can schedule you for both doses.

Some pharmacies can give both doses on the same day if you request it, though the standard spacing is two to six months apart. Ask your provider about their scheduling options when you book your first appointment.

You do not need a referral from your doctor to get the vaccine at a pharmacy, but if you prefer to receive it from your primary care doctor, you can ask them to schedule it during a regular visit or a separate vaccination appointment.

What happens if you have a Medicare Advantage plan

Medicare Advantage plans (Part C) must cover the shingles vaccine at the same cost as Original Medicare — which is zero. However, the pharmacy or provider you use must be in your plan's network. Before you schedule your vaccine, check your plan's provider directory to confirm the location is covered.

If you go to an out-of-network provider, you may be charged a higher cost or the full price of the vaccine. Call your Medicare Advantage plan's customer service number (on your insurance card) if you are unsure whether a specific pharmacy or doctor is in your network.

What to bring when you get vaccinated

Bring your Medicare card to your appointment. If you have a Medicare Advantage plan, bring that insurance card as well. The provider will scan or copy your card to confirm your coverage before giving you the vaccine.

If you do not have your Medicare card with you, you can provide your Medicare number, which is printed on other documents you may have received from Medicare. However, having the physical card makes the check-in process faster.

The two-dose schedule and timing

Shingrix requires two doses. The second dose should be given two to six months after the first dose. Both doses are covered by Medicare at no cost.

If you space the doses further apart than six months, you do not have to start over — you can straightforward continue with the second dose when you are ready. However, waiting longer than six months means you have less protection during that time, so scheduling the second dose within the recommended window is best.

Mark your calendar or ask your provider to send you a reminder when it is time for your second dose. Some pharmacies will automatically schedule your second appointment when you receive the first dose.

If you received the older shingles vaccine

If you previously received Zostavax (the older shingles vaccine), you can still receive Shingrix. Medicare covers Shingrix even if you had Zostavax in the past. There is no minimum waiting period, though most doctors recommend waiting at least 12 months after Zostavax before starting Shingrix.

Shingrix is more effective than Zostavax and provides longer-lasting protection. Because of this, the Centers for Disease Control and Prevention (CDC) recommends that anyone who previously received Zostavax should receive Shingrix as well.

Questions to ask your doctor or pharmacist

Before you get the vaccine, it is reasonable to ask:

  • Do you have Shingrix in stock, or will you need to order it?
  • When can I schedule my second dose?
  • Are there any reasons I should not receive this vaccine based on my medical history?
  • What side effects should I expect, and when should I call if I have concerns?
  • If I had Zostavax before, how long should I wait before getting Shingrix?

Frequently Asked Questions

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

No. You can go directly to any Medicare-enrolled pharmacy or provider and request the shingles vaccine without a referral. If you prefer to receive it from your primary care doctor, you can ask them to schedule it, but a referral is not required.

What if I am under 50 — does Medicare cover the vaccine?

Medicare Part B covers Shingrix only for people 50 and older. If you are under 50 and have a condition that puts you at high risk for shingles (such as a weakened immune system), talk to your doctor about whether the vaccine is right for you. Your doctor may recommend it, though Medicare would not cover it.

Will I have to pay anything out of pocket for the vaccine?

No. Medicare Part B covers the full cost of Shingrix with no copay, coinsurance, or deductible. You pay nothing for either dose. If a provider tries to charge you, contact Medicare at 1-800-MEDICARE to report it.

Can I get both doses of the vaccine on the same day?

The CDC recommends spacing the two doses two to six months apart. Some providers may allow both doses on the same day if you request it, but this is not standard practice. Ask your provider about their policy when you schedule your first appointment.

What should I do if I have a bad reaction to the first dose?

Common side effects include arm soreness, muscle aches, and fatigue for a day or two. These are normal and not dangerous. If you have a severe allergic reaction (difficulty breathing, swelling of the face or throat), call 911. For any other serious concerns, contact your doctor before scheduling your second dose.