Home » FAQ » How much does a shingles shot cost with medicare?

How much does a shingles shot cost with medicare?

The cost of a shingles shot (vaccine) under Medicare can vary depending on several factors, including the type of Medicare coverage you have, where you receive the vaccine, and whether you receive it from a participating Medicare provider.

Here’s a general breakdown of how Medicare coverage works for the shingles vaccine:

  1. Medicare Part B Coverage: The shingles vaccine, also known as Shingrix, is covered under Medicare Part B (Medical Insurance). If you have Part B coverage, Medicare will pay for 80% of the cost of the vaccine. You will be responsible for the remaining 20%. This 20% portion is typically your coinsurance, and you may also be responsible for any deductibles that apply.

  2. Medicare Advantage Plans: If you are enrolled in a Medicare Advantage (Part C) plan, your vaccine coverage may vary depending on your specific plan. Many Medicare Advantage plans provide coverage for vaccines, including the shingles vaccine, but the cost-sharing (e.g., copayments or coinsurance) can vary by plan.

  3. Medicare Prescription Drug Plans (Part D): The shingles vaccine is often covered under Medicare Part D (Prescription Drug Plans). If you have a Part D plan, you can receive the vaccine at a pharmacy or healthcare provider that participates in your plan’s network. The cost-sharing for vaccines can differ among Part D plans.

  4. Medicare Supplement (Medigap) Plans: If you have a Medicare Supplement plan, also known as Medigap, it may help cover the 20% coinsurance and any deductibles associated with the shingles vaccine, depending on your specific Medigap plan.

To get the most accurate and up-to-date information regarding the cost of the shingles vaccine with your Medicare coverage, it’s recommended to:

  1. Contact your Medicare Part D or Medicare Advantage plan, if applicable, to inquire about coverage details and cost-sharing for the shingles vaccine.
  2. Check with the pharmacy or healthcare provider where you plan to receive the vaccine to verify that they accept Medicare and participate in your specific plan’s network.
  3. Consult your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) for details on the coverage and costs associated with the vaccine.

Keep in mind that vaccine prices can vary, so it’s essential to verify the cost with your specific Medicare coverage and the provider or pharmacy where you plan to get vaccinated. Additionally, Medicare coverage and costs may change from year to year, so staying informed about your plan’s benefits is crucial.

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