Medicare covers the RSV vaccine for adults 60 and older at no cost

If you are 60 or older and enrolled in Medicare Part B, the RSV vaccine (respiratory syncytial virus vaccine) is covered with no copay, coinsurance, or deductible. Medicare treats it the same way it treats the flu and pneumococcal vaccines — as a preventive service you can receive at no out-of-pocket cost.

The vaccine is given as a single injection, usually in the upper arm. You can get it at your doctor's office, a pharmacy, a community health center, or other locations that administer vaccines. Because it is covered under Part B, you do not need prior authorization or a referral from your primary care doctor, though you can certainly ask your doctor about whether it makes sense for you.

The RSV vaccine became available to Medicare beneficiaries in 2023. It protects against respiratory syncytial virus, a respiratory infection that can be serious in older adults, causing pneumonia, hospitalization, and severe illness. Most people have had RSV at some point in their lives, but immunity fades over time, which is why the vaccine is recommended for older adults.

Key Takeaways

  • Medicare Part B covers the RSV vaccine at no cost for adults 60 and older, with no copay or deductible required.
  • You can receive the vaccine at your doctor's office, pharmacy, or any provider that administers vaccines and accepts Medicare.
  • You do not need a referral or prior authorization to get the vaccine, though discussing it with your doctor is a good idea.
  • The vaccine is a single injection and protects against a respiratory virus that can cause serious illness in older adults.

How to find a provider who administers the RSV vaccine

Start by calling your primary care doctor's office and asking whether they have the RSV vaccine in stock and whether they administer it to Medicare patients. Many primary care practices, urgent care clinics, and community health centers now carry it. If your doctor does not have it, ask for a referral to a nearby location that does.

Pharmacies are another reliable option. Major chains like CVS, Walgreens, and Rite Aid administer the RSV vaccine at their in-store pharmacies. You can call ahead to confirm they have it available, or check their websites — many allow you to schedule a vaccine appointment online. Bring your Medicare card when you go.

Your local health department may also administer the vaccine, especially if you live in a rural area or have difficulty reaching a pharmacy or doctor's office. Call your county or city health department to ask about RSV vaccine clinics or availability.

What to bring when you get the vaccine

Bring your Medicare card and a photo ID. If you have seen the provider before, they may already have your medical history on file, but it is helpful to bring a list of any medications you take and any allergies you have, especially if you are going to a new location.

If you have questions about whether the vaccine is right for you — for example, if you have had a severe allergic reaction to vaccines in the past or have a medical condition you are concerned about — mention this to the provider before the injection. They can review your health history and advise you.

What happens if you have both Medicare Part A and Part B

The RSV vaccine is covered under Part B, so your Part B coverage applies. If you have both Part A and Part B (Original Medicare), you are already covered. If you have a Medigap or Medicare Advantage plan in addition to Part B, your Part B coverage still applies, and the vaccine remains free to you.

If you have only Medicare Part A and not Part B, you are not covered for the RSV vaccine. Part A covers hospital and skilled nursing care, not outpatient preventive services. You would need to enroll in Part B to be covered for the vaccine. If you are not yet enrolled in Part B, you can enroll during the General Enrollment Period (January 1 through March 31 each year), though a late enrollment penalty may explore if you delayed enrollment without a may have access to reason.

RSV vaccine and other vaccines you may need

The RSV vaccine can be given at the same time as other vaccines, such as the flu shot, pneumococcal vaccine, or shingles vaccine. You do not have to space them out. If you are not sure which vaccines you have had or which ones you might need, ask your doctor or pharmacist to review your vaccination record.

Medicare covers several vaccines for older adults at no cost: the annual flu vaccine, pneumococcal vaccines (which protect against pneumonia and other serious infections), the shingles vaccine (Shingrix), and the RSV vaccine. Your doctor can help you decide which ones are right for your age and health history.

Side effects and what to expect after the vaccine

The RSV vaccine is a single injection. Common side effects are mild and temporary: soreness, redness, or swelling at the injection site, fatigue, muscle aches, or a low-grade fever. These usually go away within a few days. Serious side effects are rare.

After you receive the vaccine, the provider may ask you to wait 15 minutes in case you have an when ready allergic reaction. This is standard practice for any vaccine. If you develop signs of an allergic reaction — difficulty breathing, swelling of the face or throat, or severe dizziness — tell the provider right away.

If you have side effects after you leave, over-the-counter pain relievers like acetaminophen or ibuprofen can help with soreness or fever. Drink plenty of fluids and rest if you feel tired. If side effects are severe or do not improve after a few days, contact your doctor.

Medicare Advantage plans and the RSV vaccine

If you have a Medicare Advantage plan (Part C), your plan must cover the RSV vaccine at no cost because it is a Part B preventive service. You still have no copay or deductible. You can receive the vaccine from any in-network provider, or in some cases from an out-of-network provider if an in-network provider is not available.

Check your plan's provider directory to find in-network locations near you, or call the customer service number on your plan card. If you are unsure whether a specific pharmacy or clinic is in your plan's network, ask before you go, so you are not surprised by a bill.

Frequently Asked Questions

Do I have to get the RSV vaccine if I am on Medicare?

No, the vaccine is not required. It is recommended for adults 60 and older, but whether to get it is your choice. Talk with your doctor about your personal health and risk factors to decide what is right for you.

Can I get the RSV vaccine if I am under 60?

Medicare covers it only for adults 60 and older. If you are younger and interested in the vaccine, ask your doctor whether it might be right for you and what it would cost outside of Medicare coverage.

What if I already had RSV recently — can I still get the vaccine?

Yes. Having had RSV in the past does not prevent you from getting the vaccine. Your immunity from a past infection fades over time, which is why the vaccine is recommended even if you have had the virus before.

Will the RSV vaccine protect me completely from getting RSV?

The vaccine significantly reduces your risk of severe RSV illness and hospitalization, but it does not may provide you will never get RSV. It works similarly to the flu vaccine — it lowers your chances of getting sick and reduces how serious illness is if you do get infected.

Can I get the RSV vaccine at the same time as my flu shot?

Yes, you can receive the RSV vaccine and flu vaccine in the same visit, in different arms. You can also receive other vaccines like the pneumococcal or shingles vaccine at the same time. There is no need to wait between them.