What vaccines does Medicare cover for seniors?

Oct 18, 2025 3 min read •

senior care Medicare Healthy Aging

According to the Centers for Medicare & Medicaid Services, the Inflation Reduction Act of 2022 eliminated out-of-pocket costs for many recommended vaccines. Understanding what vaccines does Medicare cover for seniors is a vital part of staying healthy and managing healthcare expenses, as coverage depends on which part of Medicare you have.

Quick Summary

Medicare covers a wide range of essential vaccines for seniors, with coverage split between Part B and Part D. Beneficiaries generally pay nothing out-of-pocket for all adult vaccines recommended by the CDC's Advisory Committee on Immunization Practices (ACIP), including shots for flu, pneumonia, COVID-19, RSV, and shingles. Knowing which part covers which vaccine is crucial to ensure proper coverage.

Key Points

Parts B and D Cover Different Vaccines: Medicare Part B covers specific shots like flu and pneumonia, while Part D covers most others, including shingles and RSV.
No Out-of-Pocket Costs for Recommended Vaccines: Thanks to recent legislation, most recommended adult vaccines are covered by Medicare with no copayment or deductible.
Network Restrictions Apply: For Part D and Medicare Advantage plans, you must generally use an in-network provider or pharmacy to get the vaccine at no cost.
Check Your Plan's Formulary: Always review your specific Part D or Medicare Advantage plan's list of covered drugs and vaccines (formulary) to confirm coverage.
Some Vaccines Aren't Covered: Medicare typically does not cover vaccines needed for international travel, so you may need to pay for these out-of-pocket.
Consult Your Doctor: Always discuss your individual vaccination needs with your healthcare provider to determine the best immunization schedule for your health.

Understanding Medicare's vaccine coverage

For seniors, staying up-to-date with vaccinations is a critical component of preventive healthcare. As immune systems naturally weaken with age, the risk for serious complications from common illnesses like influenza and pneumonia increases. Fortunately, Medicare provides comprehensive coverage for a wide array of vaccines, helping to protect beneficiaries without adding financial stress. However, coverage isn't uniform across all Medicare parts, and knowing which part covers which vaccine is key to navigating the system effectively. The distinction lies primarily between Medicare Part B (Medical Insurance) and Medicare Part D (Prescription Drug Coverage).

Vaccines covered by Medicare Part B

Medicare Part B covers specific vaccines typically administered in a doctor's office or outpatient setting. For these, beneficiaries generally pay nothing out-of-pocket if their healthcare provider accepts Medicare assignment. Part B covers the annual flu shot, pneumococcal shots for pneumonia, and all FDA-approved COVID-19 vaccines and boosters. It also covers Hepatitis B shots for those at high or medium risk.

Vaccines covered by Medicare Part D

Vaccines not covered under Part B are typically covered through a Medicare Part D plan or a Medicare Advantage Plan with drug coverage. The Inflation Reduction Act of 2022 eliminated cost-sharing for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) when covered by Part D. This means no copayments or deductibles for these covered vaccines. Examples include the shingles vaccine (Shingrix) for adults 50 and older and the RSV vaccine for adults 60 and older. The Tdap vaccine for tetanus, diphtheria, and pertussis is also covered under Part D.

Comparing vaccine coverage under Medicare Parts B and D

Understanding the distinction between Part B and Part D is crucial. The table below provides a quick comparison of coverage differences.


Feature	Medicare Part B	Medicare Part D	Medicare Advantage Plan
Primary Function	Medical insurance for outpatient services	Prescription drug coverage	Bundles Part A, B, and often D
Vaccines Covered	Flu, pneumococcal, COVID-19, high-risk Hepatitis B	Shingles, RSV, Tdap, Hepatitis A, most others recommended by ACIP	Same coverage as Original Medicare (Parts A & B) plus additional Part D coverage
Out-of-Pocket Costs	None for covered vaccines administered by a provider who accepts Medicare assignment.	None for ACIP-recommended vaccines due to Inflation Reduction Act.	None for ACIP-recommended vaccines, though you may need to use an in-network provider or pharmacy.
Where to Get Vaccinated	Doctor's office, clinic, or other medical facility	Pharmacy, clinic, or doctor's office (must be within plan network).	In-network pharmacies or providers.

Navigating coverage for specific situations

If you don't have a Medicare Part D plan, you will be responsible for the cost of vaccines typically covered under Part D. While most Medicare Advantage plans include Part D, it's essential to confirm your plan's details. For vaccines needed due to injury or exposure, like a tetanus shot, Part B may cover it. Medicare generally does not cover vaccines required for international travel.

Actionable steps for seniors

Review your plan: Check your Medicare Part D or Medicare Advantage plan documents and formulary to understand your specific vaccine coverage.
Consult your doctor: Discuss recommended vaccines based on your age, health, and risks.
Utilize in-network providers: For Part D and Medicare Advantage plans, use in-network providers or pharmacies for no-cost vaccinations.
Confirm coverage beforehand: Contact your pharmacy or provider to verify coverage and no-cost access for the specific vaccine.

Conclusion

Medicare provides extensive coverage for essential vaccines at no or minimal cost. By understanding coverage under Parts B and D and reviewing your plan, you can ensure you receive recommended immunizations. Prioritizing preventive care, including vaccines, is vital for healthy aging.

For additional information, visit the official Medicare website www.medicare.gov.

Frequently Asked Questions

Medicare Part B covers specific preventive vaccines like the annual flu shot, COVID-19 vaccine, and pneumococcal shots for pneumonia. Medicare Part D, which is prescription drug coverage, covers all other adult vaccines recommended by the CDC's ACIP, including the shingles (Shingrix) and RSV vaccines.

Yes, the shingles vaccine (Shingrix) is covered by Medicare. It is covered under Medicare Part D, and beneficiaries with Part D pay no out-of-pocket costs for it.

For most adult vaccines recommended by the ACIP, beneficiaries pay nothing out-of-pocket. The Inflation Reduction Act of 2022 eliminated cost-sharing for these vaccines under both Part B and Part D.

Yes, Medicare Part B covers the COVID-19 vaccine and any updated boosters, and there are no out-of-pocket costs for beneficiaries when they receive the shot from a provider who accepts Medicare assignment.

You can check your plan's formulary (for Part D coverage) or call your plan provider directly. It is also a good practice to contact the pharmacy or doctor's office before your visit to confirm your specific vaccine is covered at no cost.

Generally, yes. Medicare Advantage plans must cover at least the same benefits as Original Medicare (Parts A and B). Most also include Part D coverage, which covers additional vaccines like shingles and RSV.

No, Medicare typically does not cover vaccines required for international travel. You will likely have to pay for these travel-specific shots out-of-pocket, although some Medicare Advantage plans might offer limited coverage.

With Medicare Part D, vaccines recommended by ACIP are covered at no cost-sharing even if you get them from an out-of-network provider. You can get reimbursed by your plan. However, with Medicare Advantage plans, you may be required to use an in-network provider to ensure full coverage.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.