Does Medicare Cover the Shingles Vaccine in 2023?

Medicare and the Shingles Vaccine

In most cases, Original Medicare (Parts A and B) will not cover vaccinations and immunizations. The exceptions to this rule are vaccines for influenza, pneumonia, hepatitis B, and COVID-19. Part B can also cover vaccinations needed following exposure to a dangerous virus or disease. This could include tetanus shots after scraping yourself on a rusty nail or rabies shots after getting bitten by a dog.

Other vaccinations, including those for shingles, will require you to either pay out of pocket or use a different form of coverage such as private insurance or Medicare Part D.

Medicare Part D and Shingles Vaccine

Medicare Part D plans help cover the cost of prescription drugs, including vaccinations for shingles.

Shingrix and Zostavax are the two commercially available shingles vaccines, and they tend to cost about $190 to $240 per shot; however, a Medicare Part D plan can cover this cost. Alternatively, a Medicare Advantage plan that includes Part D coverage can also offer similar benefits.

That said, most Medicare Part D plans will have a deductible. Until you reach this deductible, you’ll be responsible for paying for any vaccinations or other drugs.

Medicare and Other Vaccinations

In addition to the shingles vaccine, Medicare Part D plans are required to cover most commercially available vaccinations. According to the Department of Health and Human Services, Medicare Part D plans must cover all vaccines that are commercially available, reasonable and necessary to prevent illness, and not covered by Medicare Part B.

How to Get the Shingles Vaccine

The shingles vaccine can be obtained in one of two places.

Pharmacy

Most chain pharmacies offer the shingles vaccine; however, you’ll need a doctor’s prescription. If you’re unsure which pharmacies near you offer the vaccine, call your provider or pharmacy directly.

Doctor’s Office

You can also receive a shingles vaccine from a doctor’s office. Be sure to check whether they can bill your plan directly or if they work with a pharmacy that can. If your doctor can, you’re responsible for the copayment. If not, you may have to pay the full cost upfront and then file a reimbursement claim with your plan.

Keep in mind that the doctor’s fee for delivering the vaccine may go over your plan’s permissible charge. If so, you’re required to pay the difference.

Bottom Line

While Medicare can cover the shingles vaccine, it’s only Part D. If you do have coverage, it never hurts to call your local pharmacy or doctor’s office to see if they administer the vaccine and accept your insurance. If you don’t have this coverage, simply go to Medicare.gov to see which plans are offered near you.

To learn more about Medicare coverage, be sure to check out our helpful guides:

• Medicare and COVID-19 Testing
• Does Medicare Cover Glasses?
• Medicare Coverage of Long-Term Care
• Medicare and Memory Care