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Does Medicare cover the shingles vaccine shots?

Does your Medicare plan cover the shingle vaccine shots? Who is at risk, why you need it, and how much it costs?

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Yes, Medicare does cover the shingles vaccine, and it's a good thing, too, because an estimated 1 million people in the United States get shingles each year. In addition, the Centers for Disease Control and Prevention reports about 1 out of 3 people in the United States will develop shingles in their lifetime.

To get coverage for the shingles shot, you need to have a Medicare Part D prescription drug plan. You can enroll in a stand-alone Part D drug plan if you have Original Medicare Part A or Part B. If you have both Part A and Part B, you can enroll in a Medicare Advantage plan with drug coverage.

Needle into shingle vaccine
Shingles skin rash on back
  • Shingles mainly affect older adults who had chickenpox when they were younger. If you are a senior age 65 or older, you may have an increased risk of developing shingles. The painful, blistering rash can cover many areas of your body, including the waist, chest, stomach, buttocks, neck, or face.

  • People usually recover from shingles within a few weeks. However, in rare cases, shingles can have severe complications, including death. In other cases, people experience Postherpetic Neuralgia and continue to have pain in the area where the rash had been for months or years after the skin has healed.

  • The shingles vaccination may helps reduce the risk of contracting shingles and can lessen the length and severity of illness. You can get the Zostavax shot (zoster vaccine live) or Shingrix shots (zoster vaccine recombinant). A study showed  the new Shingrix vaccine is more effective in subjects ages 50 and older. 

How Much Does Shingles Vaccine Cost Under Medicare?

Before a Medicare Part D or Medicare Advantage plan pays anything, you may need to pay the annual deductible. Typically, the shingles vaccine is a tier 3 drug with a higher deductible. Deductibles vary between Medicare drug plans. However, the maximum deductible you pay in 2023 is $505. (Medicare.gov )

Your shingles vaccine costs maybe $150 to $200 before you meet your plan’s deductible. After you pay your plan’s deductible, it may cost $20 to $50. Your shingle’s vaccine cost will vary by Medicare plan and the type of shingles vaccine.

Senior Healthcare Direct can help you find the right Medicare Advantage plan that includes your drug coverage for the shingles vaccine or a Medicare Part D plan that’s right for you. 

Common Questions about Shingles Vaccine

What is Shingles Vaccine?

Shingles is a viral infection that affects the nerves. The shingles virus, also called Herpes Zoster, produces a painful rash with blisters. The shingles vaccine may reduce your risk of developing shingles.

Does Medicare cover shingles vaccine?

Original Medicare Part A or Part B does not cover the shingles vaccine. However, Medicare Part D and Medicare Advantage plans with drug coverage do cover the shingles vaccine.

Who should get the new Shingrix vaccine?

Anyone ages 50 and older should get the new Shingrix vaccine. The Shingrix vaccine has been shown to be the best way to protect yourself against shingles, according to the Centers for Disease Control and Prevention . In addition, the Shingrix vaccine is covered by Medicare Part D and Medicare Advantage plan with drug coverage.

How effective is the Shingrix vaccine?

Shingrix has been shown to be more than 90% effective at preventing shingles and long-term nerve pain.

Who can get shingles?

Anyone who has had chickenpox can get shingles. More than 99% of Americans born before 1980 have had chickenpox, even if they do not remember it.

Who has an increased risk of getting shingles?

The risk for getting shingles and complications increases as you age. Adults ages 65 and older who are eligible for Medicare Part D or Medicare Advantage plan with drug coverage can get shingles vaccine coverage.

Who should get the shingles vaccine?
Where and how to get the shingles vaccine?

You can get the shingles vaccine at a pharmacy in your network. For adults ages 50 and older who want the most effective shingles vaccine, you can find a pharmacy or doctor near you for a Shingrix shot.

How are the shingles vaccines administered?

The Zostavax vaccine shot is subcutaneous (under your skin) and a one-time injection. However, the Shingrix shingles shot is intramuscular and requires two injections. The second dose is given 2 - 6 months after your first dose.

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