Recent rules made the shingles vaccine free for most people on Medicare. Here's how your coverage works.
How does Medicare cover the shingles vaccine?
The shingles vaccine, Shingrix, is covered under Medicare Part D (prescription drug coverage) and through Medicare Advantage plans that include drug coverage. Thanks to recent law, recommended adult vaccines covered under Part D, including the shingles vaccine, are provided with no out-of-pocket cost, meaning no copay and no deductible. Shingrix is given as two doses, and both are covered. Importantly, the shingles vaccine is not covered under Medicare Part B, so you need a Part D plan or a Medicare Advantage plan with drug coverage to get it free. If you don't have drug coverage, you'd pay out of pocket. Call 1-800-MEDIGAP at 1-800-633-4427.
Make sure you have the right coverage
Because the shingles vaccine falls under Part D rather than Part B, your access depends on having Medicare drug coverage. If you have a standalone Part D plan or a Medicare Advantage plan that includes drugs, you can typically get Shingrix at a pharmacy at no cost. If you only have Original Medicare without a Part D plan, the vaccine isn't covered and you'd pay the full price, which can be over $300 for both doses. Going without Part D can also trigger a lifelong late-enrollment penalty. To make sure you have the drug coverage you need, call 1-800-MEDIGAP for a free review.