Medicare covers most vaccines, but leaves gaps that can cost you hundreds of dollars out of pocket
Medicare Part B covers the flu shot, pneumococcal vaccines, and COVID-19 vaccines at no cost to you. But Medicare has significant gaps: it does not cover shingles vaccine (Shingrix), RSV vaccine, mpox vaccine, or travel vaccines like yellow fever and Japanese encephalitis. Part D (prescription drug coverage) does not cover vaccines at all. If you need one of the uncovered vaccines, you will pay the full price yourself — which ranges from $150 to $400 per shot depending on the vaccine.
The reason for these gaps is historical and bureaucratic rather than medical. Medicare was written to cover vaccines given in a doctor's office as an injection (Part B), but not vaccines given in a pharmacy or as a pill. Shingrix, the most common uncovered vaccine for older adults, costs around $300 for the two-shot series and is not covered by Medicare even though shingles causes serious pain and disability in people over 50.
Key Takeaways
- Medicare Part B covers flu, pneumococcal, and COVID-19 vaccines at no cost, but does not cover shingles (Shingrix), RSV, or mpox vaccines.
- Shingrix costs approximately $150 to $200 per shot and requires two doses, making the full series $300 to $400 out of pocket.
- Some state Medicaid programs and private insurance plans cover shingles vaccine even when Medicare does not.
- Pharmacies, community health centers, and some employers offer shingles vaccine at reduced rates if you ask about discount programs.
- Travel vaccines are never covered by Medicare and must be paid out of pocket at travel clinics or pharmacies.
Which vaccines Medicare Part B covers at no cost
Medicare Part B pays for the seasonal flu vaccine (one shot per year), pneumococcal vaccines (Pneumovax 23 and Prevnar 20, depending on your age and health history), and COVID-19 vaccines (updated annually). You do not pay a copay, coinsurance, or deductible for these vaccines when you receive them at a doctor's office, hospital outpatient department, or participating pharmacy.
Part B also covers the hepatitis B vaccine if you have chronic kidney disease or are on dialysis, and the Td or Tdap vaccine (tetanus, diphtheria, pertussis) if you have never received one or need a booster. These are covered because they are given as injections in a medical setting and were included in Medicare's original vaccine list.
Shingrix (shingles vaccine) — the biggest coverage gap
Shingrix is the vaccine most Medicare beneficiaries ask about and most are surprised to learn is not covered. It prevents shingles (herpes zoster), a painful rash that develops in one in three people over age 50 and can cause long-term nerve pain called postherpetic neuralgia. The CDC recommends Shingrix for all adults 50 and older, regardless of whether they have had shingles before.
Shingrix requires two doses given two to six months apart. The cost per dose ranges from $150 to $200 at most pharmacies and doctor's offices, making the full series $300 to $400. Some Medicare Advantage plans (Part C) do cover Shingrix — check your plan's formulary or call the plan directly to ask. If your plan does not cover it, you pay the full amount yourself.
If cost is a barrier, ask your pharmacy or doctor's office about manufacturer discounts or patient information programs. Some community health centers offer Shingrix at a reduced rate based on income. A few state Medicaid programs also cover Shingrix for people who are dually may be able to access for both Medicare and Medicaid.
RSV and mpox vaccines — newer vaccines not yet covered
RSV (respiratory syncytial virus) vaccine became available in 2023 and is recommended for adults 60 and older, especially those with chronic heart or lung disease. Medicare does not cover it. The vaccine costs around $200 to $300 per dose, and most people need only one dose.
Mpox vaccine (formerly called monkeypox vaccine) is not routinely recommended for older adults unless you have specific risk factors, but it is not covered by Medicare if you do need it. The cost is typically $100 to $150 per dose, and the series requires two doses.
Coverage for these newer vaccines may change as Medicare updates its policies, but as of now you will pay out of pocket. Check with your doctor about whether either vaccine is right for you based on your health and risk factors.
Travel vaccines Medicare will not pay for
If you travel internationally, you may need vaccines like yellow fever, Japanese encephalitis, typhoid, or hepatitis A. Medicare does not cover any travel vaccines, even if your doctor recommends them for a trip to a high-risk country. You will pay the full cost at a travel clinic or pharmacy.
Travel vaccine costs vary widely. Yellow fever vaccine costs $100 to $150. Hepatitis A costs $40 to $80 per dose (two doses needed). Japanese encephalitis runs $200 to $300 per dose. Many travel clinics bundle vaccines and offer package pricing, so call ahead and ask. Some pharmacies offer discounts if you are paying out of pocket.
How to find lower-cost options for uncovered vaccines
If you need a vaccine Medicare does not cover, start by calling your pharmacy and asking whether they have a discount program or manufacturer coupon. Many pharmacies participate in programs like GoodRx or RxSaver that can lower the price by 20 to 40 percent.
Community health centers often offer vaccines at a sliding fee scale based on income — you may pay nothing or a small amount depending on what you earn. Use the HRSA Find a Health Center tool on the HRSA website to locate a center near you. Some employers and unions also offer vaccines to retirees; if you have retiree health benefits, ask whether they cover Shingrix or other vaccines.
If you have a Medicare Advantage plan (Part C), check your plan's formulary or call the plan to ask whether it covers the vaccine you need. Some plans do cover Shingrix or RSV vaccine even though Original Medicare does not. Your plan may also have a preferred pharmacy where the cost is lower.
Why Medicare's vaccine coverage has gaps
Medicare's vaccine coverage rules were written in 1965 and have not kept pace with new vaccines or changes in how vaccines are delivered. Part B covers vaccines given as injections in a doctor's office, but Part D (pharmacy coverage) explicitly excludes all vaccines. This means vaccines given at a pharmacy — even if they are injections — often fall into a gap.
Shingrix is a good example. It is an injection, but it is commonly given at pharmacies by pharmacists, not in a doctor's office. Because of how Medicare's rules are written, it is not covered. Advocacy groups have pushed Congress to update Medicare vaccine coverage, but change has been slow.
Frequently Asked Questions
Does Medicare Advantage cover Shingrix?
Some Medicare Advantage plans do cover Shingrix, but not all. Check your plan's formulary or call your plan's customer service line to ask. If your plan covers it, you may pay a copay or coinsurance rather than the full price. If your plan does not cover it, you pay out of pocket.
Can I get a shingles vaccine at my doctor's office instead of a pharmacy?
Yes, many doctor's offices stock and administer Shingrix. However, Medicare still will not cover it even if given in a doctor's office, because the vaccine itself is not on Medicare's covered vaccine list. You will pay the same out-of-pocket cost regardless of where you receive it.
Will Medicare ever cover Shingrix?
There is no announced timeline for Medicare to add Shingrix to its covered vaccine list. Advocacy groups continue to push for coverage, but Congress would need to pass legislation to change Medicare's rules. Check back with your doctor or Medicare's website periodically for updates.
What if I cannot afford an uncovered vaccine?
Ask your doctor or pharmacist about manufacturer patient information programs, which sometimes offer free or reduced-cost vaccines based on income. Community health centers offer sliding-scale fees. Some state Medicaid programs cover vaccines for people dually may be able to access for Medicare and Medicaid. Pharmacies may also have discount programs or coupons.
Are travel vaccines ever covered by any part of Medicare?
No. Travel vaccines are not covered by Original Medicare, Medicare Advantage, or Part D. You will pay out of pocket at a travel clinic or pharmacy. Call ahead to ask about package pricing or discounts if you need multiple vaccines for a trip.