Medicare beneficiaries are accustomed to having vaccines like seasonal flu, tetanus, and pneumonia covered by Medicare Part B. The assumption would be that the shingles vaccine would be covered in the same way, but that is NOT the case.
The shingles vaccine is covered by your Part D or Prescription Drug plan.
Shingrix is the name of the vaccine available for shingles. Medicare will ONLY cover the cost of these vaccines if you have a stand-alone prescription drug plan OR a Medicare advantage/prescription drug plan (MAPD).
Just how much will you pay for the vaccine? Well, that can vary significantly depending on your particular drug or MAPD plan. If you have not met your yearly deductible, you may pay +/- $217 for the vaccine. If you’ve met your deductible, you would have to pay the required co-pay according to your specific drug or MAPD plan.
There are two options for getting the vaccine. You can opt to get the vaccine in a doctor’s office or have your doctor write a prescription and get the prescription filled at your local pharmacy and have your pharmacist administer the shot.
If you opt to have the vaccine administered in your doctor’s office, be prepared to have fees added in for the doctor’s professional fees as well as facility charges. Should you decide to go the route of having your vaccine administered by your pharmacist, you will eliminate the professional and facility fees, and just pay the cost of the vaccine.
Keep in mind that the initial vaccine is good for 5 years. Many doctors recommend receiving a second or “booster” shot, so you may be paying for another series of shots in the future.
