What Medicare covers in vaccines
Medicare Part B covers four vaccines for people 65 and older: the flu shot, pneumococcal vaccines (pneumonia), the shingles vaccine, and the RSV vaccine. Part B also covers the COVID-19 vaccine and the Tdap vaccine (tetanus, diphtheria, pertussis) if you have never had one as an adult. You pay nothing out of pocket for these vaccines at a participating provider — Medicare covers the full cost.
The coverage applies whether you get the shot at your doctor's office, a pharmacy, a health department clinic, or a hospital. If you have Part D prescription drug coverage, some pharmacies may bill Part D instead of Part B, but your cost remains zero either way. The key is that the provider must accept Medicare.
If you get a vaccine at a provider who does not accept Medicare, you will pay the full price upfront and then file a claim yourself — a slower and more complicated process. Always confirm the provider accepts Medicare before your appointment.
Key Takeaways
- Medicare Part B covers flu, pneumococcal, shingles, RSV, COVID-19, and Tdap vaccines with no cost to you at a participating provider.
- You need a new flu shot every year, but pneumococcal and shingles vaccines follow a specific schedule based on your age and previous shots.
- Confirm your provider accepts Medicare before your appointment, because out-of-network providers require you to pay upfront and claim reimbursement later.
- If you have Part D coverage, some pharmacies may bill your drug plan instead of Part B, but your out-of-pocket cost stays zero.
Flu vaccine: annual coverage every year
Medicare covers one flu shot per flu season at no cost. The flu season runs from October through March, though you can get the shot as early as September. You need a new shot every year because the flu virus changes and the vaccine is reformulated annually to match the expected strains.
You can get the flu shot at your doctor's office, a pharmacy, a health department, or a hospital. Many pharmacies offer walk-in flu shots without an appointment. If you have a chronic condition like heart disease, diabetes, or COPD, getting the flu shot is especially important because the flu can trigger serious complications in people with these conditions.
Some people worry about side effects. The most common are a sore arm, mild fever, or body aches for a day or two. Severe allergic reactions are rare. If you have had a severe reaction to a flu shot in the past, tell your provider before getting another one.
Pneumococcal vaccines: the schedule depends on your age
Pneumococcal vaccines protect against pneumonia and other infections caused by pneumococcus bacteria. Medicare covers two types: pneumococcal conjugate vaccine (PCV) and pneumococcal polysaccharide vaccine (PPSV23). The schedule changed in 2024, and the new approach depends on whether you have already had pneumococcal shots.
If you are 65 or older and have never had a pneumococcal vaccine, you should get one dose of PCV20 (a single newer vaccine) or follow an older two-shot sequence with PCV15 followed by PPSV23. If you already had PPSV23 before age 65, you need a dose of PCV20 at 65 or later. If you had PCV13 in the past, the sequence is different again. The exact path depends on what you have already received and when.
Because the schedule is complex and changed recently, ask your doctor which shot you need and when. Do not assume you are covered just because you had a pneumococcal shot years ago — the new recommendations may mean you need another one. Your doctor's office can check your vaccination record and tell you what comes next.
Shingles vaccine: two doses, two to six months apart
Medicare covers the shingles vaccine (Shingrix) for people 50 and older. You need two doses, given two to six months apart. Most people get the second dose four to six months after the first. You pay nothing for either dose at a participating provider.
Shingles is a painful rash caused by the same virus that causes chickenpox. It can develop years or decades after you had chickenpox, even if you do not remember having it. The vaccine reduces your risk of shingles by about 90 percent and reduces the pain if you do get it. If you already had shingles, you can still get the vaccine — it helps prevent it from happening again.
If you had the older shingles vaccine (Zostavax) in the past, you should still get Shingrix. Ask your doctor how long to wait after Zostavax before starting Shingrix — the timing depends on your immune system and other factors.
RSV and COVID-19 vaccines: newer coverage for older adults
Medicare began covering the RSV vaccine in 2023 for people 60 and older. RSV (respiratory syncytial virus) causes a respiratory infection that can be serious in older adults, leading to pneumonia or hospitalization. You need one dose of the RSV vaccine. It is a newer vaccine, so fewer people have had it yet, but it is available at most pharmacies and doctor's offices that accept Medicare.
The COVID-19 vaccine has been covered by Medicare since 2021. You may need a booster dose depending on when you last had COVID-19 or a COVID vaccine. The CDC and your doctor can tell you whether you need an updated dose. Like other Medicare-covered vaccines, COVID-19 shots cost you nothing at a participating provider.
Tdap vaccine: one dose if you never had it as an adult
The Tdap vaccine protects against tetanus, diphtheria, and pertussis (whooping cough). Medicare covers one dose for people 65 and older who have never had Tdap as an adult. If you had Tdap before, you do not need another one under Medicare coverage — though your doctor may recommend a tetanus booster (Td) every 10 years, which is also covered.
Tdap is important if you spend time around infants, because pertussis can be life-threatening in babies. If you are a grandparent or caregiver, getting Tdap protects the youngest people around you. The vaccine is safe and side effects are usually mild.
Where to get vaccines and how to confirm coverage
You can get any Medicare-covered vaccine at a doctor's office, a pharmacy (CVS, Walgreens, and most others accept Medicare), a health department clinic, or a hospital. Many pharmacies offer walk-in appointments and do not require you to call ahead. Some offer evening and weekend hours, which can be more convenient than waiting for a doctor's appointment.
Before you go, call ahead or check the provider's website to confirm they accept Medicare. If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your coverage may be slightly different — check your plan documents or call the plan to confirm which vaccines are covered and whether you have any cost-sharing.
Bring your Medicare card with you. If you have Part D coverage, the pharmacy may ask whether to bill Part B or Part D — either way, your cost is zero. If the provider says you owe money, ask why, because these vaccines should cost you nothing under Medicare.
Frequently Asked Questions
Do I need the flu shot if I got COVID-19 recently?
Yes. Having COVID-19 does not protect you from the flu, and having both at the same time can be more serious than either alone. You can get the flu shot and COVID-19 booster at the same visit if you need both. There is no waiting period between them.
What if I am allergic to eggs?
Most flu vaccines are safe for people with egg allergies because they contain very little egg protein. Tell your provider about the allergy before your shot. They can give you a flu vaccine that is egg-free or monitor you for a short time after the shot. Do not skip the flu vaccine because of an egg allergy — your provider can work around it.
Can I get vaccines if I am on blood thinners?
Yes, but tell your provider you are on blood thinners before the shot. They may use a smaller needle or explore pressure longer after the injection to prevent bruising. The vaccine itself is safe; the precaution is just about the injection technique.
What if my doctor recommends a vaccine that is not on this list?
Medicare may cover other vaccines in specific situations — for example, hepatitis B for people with diabetes or kidney disease, or meningococcal vaccine for certain conditions. Ask your doctor whether Medicare covers the vaccine they are recommending and whether you have any out-of-pocket cost.
Do I need to show proof of vaccination?
Your doctor's office keeps a record of your vaccines in your medical file. If you need proof for travel or another reason, ask your provider for a copy. You can also request a vaccination record from Medicare by calling 1-800-MEDICARE.