Medicare Part B covers most vaccines you need as an adult

Medicare Part B pays for vaccines that prevent serious diseases common in older adults. The vaccines covered include flu, pneumonia, shingles, COVID-19, and tetanus. Part B covers the full cost of these vaccines with no copay or coinsurance when you get them at a participating provider — you pay nothing out of pocket.

The specific vaccines available to you depend on your age, health history, and what your doctor recommends. Medicare updates its vaccine coverage each year, so the list can change. Your doctor or pharmacist can tell you which vaccines you need based on your medical history and current guidelines.

Key Takeaways

  • Medicare Part B covers flu, pneumonia, shingles, COVID-19, and tetanus vaccines at no cost to you when given by a participating provider.
  • You do not need to pay a copay or coinsurance for covered vaccines — Medicare pays the full amount.
  • Your doctor or pharmacist determines which vaccines you need based on your age, health conditions, and vaccination history.
  • You can get covered vaccines at your doctor's office, a hospital, or a pharmacy that accepts Medicare.
  • Some vaccines require more than one dose given weeks or months apart, so ask your provider about the full schedule.

Flu vaccine — covered every year

Medicare Part B covers one flu vaccine per flu season at no cost. The flu season typically runs from October through March, though you can get vaccinated earlier or later in the year. Most people get the flu shot, which is injected into the arm. A nasal spray flu vaccine is also available for some adults, though it is less commonly used.

You can get your flu vaccine at your doctor's office, an urgent care clinic, a pharmacy, or a hospital — anywhere that participates in Medicare. You do not need an appointment at many pharmacies; you can walk in during their vaccine hours. If you have questions about which type of flu vaccine is right for you, ask your doctor or pharmacist before your visit.

Pneumonia vaccines — two shots given at different times

Medicare Part B covers two pneumonia vaccines: Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumococcal Conjugate Vaccine (PCV20 or PCV15). Most people over 65 need both vaccines, but the order and timing depend on your age and whether you have had pneumonia vaccines before.

If you have never had a pneumonia vaccine, your doctor will recommend which one to start with and when to get the second one. If you had a pneumonia vaccine years ago, you may need a booster dose now. The two vaccines are given as separate injections, usually in different arms, and you may need to wait weeks or months between them. Your doctor will explain the schedule based on your specific situation.

Shingles vaccine — two doses required

Medicare Part B covers Shingrix, the shingles vaccine, for adults 50 and older. You need two doses given two to six months apart. Both doses are covered at no cost. Shingrix is much more effective than an older shingles vaccine called Zostavax, which Medicare no longer covers.

You can get Shingrix at your doctor's office or a pharmacy. After your first dose, ask when to schedule your second dose — your provider will have a record and can remind you when it is time. Some people experience arm soreness or mild fever after the shot, which is normal and goes away in a day or two.

COVID-19 vaccine — updated doses available

Medicare Part B covers COVID-19 vaccines and updated booster doses at no cost. The vaccine you receive depends on which vaccines are currently recommended by the Centers for Disease Control and Prevention (CDC). The recommendations change as new variants emerge, so the specific vaccine available may differ from year to year.

You can get a COVID-19 vaccine at your doctor's office, a pharmacy, a hospital, or a public health clinic. If you are unsure whether you need an updated dose, ask your doctor or check the CDC website for current recommendations. Medicare covers the vaccine regardless of your citizenship or immigration status.

Tetanus vaccine — booster every 10 years

Medicare Part B covers tetanus vaccine as part of the Tdap or Td vaccine. Tdap protects against tetanus, diphtheria, and pertussis (whooping cough). Td protects against tetanus and diphtheria only. Most adults need a tetanus booster every 10 years, though your doctor may recommend one sooner if you have a deep wound or burn.

You can get a tetanus booster at your doctor's office or a pharmacy. If you are not sure when you last had a tetanus shot, ask your doctor to check your records. Medicare covers the full cost with no copay.

Other vaccines Medicare Part B may cover

Medicare Part B also covers vaccines for hepatitis B, hepatitis A, measles, mumps, rubella, and meningococcal disease in certain situations. Coverage depends on your age, health conditions, and whether your doctor thinks you need the vaccine. For example, hepatitis B vaccine is covered for all adults 19 to 59 years old and for adults 60 and older with certain risk factors.

If your doctor recommends a vaccine not listed here, ask whether Medicare Part B covers it. Your doctor can check your coverage before you receive the vaccine so you know whether you will have any out-of-pocket costs. Some vaccines may be covered under Part D (prescription drug coverage) instead of Part B, depending on where you get them.

How to get your vaccines covered

To get a vaccine covered by Medicare Part B, you need to visit a provider who accepts Medicare. This includes doctors' offices, hospitals, urgent care clinics, and most pharmacies. When you arrive, bring your Medicare card. Tell the staff which vaccines you need or ask which ones your doctor has recommended for you.

If you are not sure which vaccines you need, call your doctor's office and ask. Your doctor can review your vaccination history and tell you which vaccines are right for you based on your age and health. You can also ask your pharmacist — many pharmacies now have pharmacists who can recommend vaccines and give them to you on the spot.

Medicare pays the provider directly, so you should not receive a bill. If you do receive a bill for a covered vaccine, contact Medicare or the provider to find out why. Keep a record of which vaccines you received and when — this helps your doctor know what you still need.

Frequently Asked Questions

Do I have to pay anything for vaccines covered by Medicare Part B?

No. Medicare Part B covers the full cost of covered vaccines with no copay, coinsurance, or deductible. You pay nothing out of pocket. If a provider bills you for a covered vaccine, contact Medicare to report it.

Can I get vaccines at a pharmacy instead of my doctor's office?

Yes. Most pharmacies accept Medicare and can give you covered vaccines. Many pharmacies offer walk-in vaccine appointments, so you do not need to schedule ahead. Bring your Medicare card when you go.

What if I had vaccines before I turned 65 or before I enrolled in Medicare?

Tell your doctor or pharmacist about any vaccines you had in the past. They can check your records and tell you which vaccines you still need. Some vaccines require boosters years later, and Medicare covers those boosters even if you got the original vaccine before Medicare.

Do I need my doctor's permission to get a vaccine at a pharmacy?

No. You can walk into a pharmacy and get a covered vaccine without seeing your doctor first. However, if you have questions about which vaccines you need or whether a vaccine is safe for you given your health conditions, ask your doctor before you go.

What happens if Medicare Part B does not cover a vaccine my doctor recommends?

Ask your doctor why the vaccine is not covered and whether you need it. Some vaccines may be covered under a different part of Medicare, or your doctor may recommend waiting. If you decide to get an uncovered vaccine, ask the provider what it will cost before you receive it.