August is National Immunization Awareness Month, an annual commemoration that aims to emphasize the importance of vaccination and encourage people of all ages to stay up to date with immunizations. A person needs immunization based on age, medical history and other conditions, as well as risk and exposure levels.
How Medicare covers vaccines
Medicare covers preventive care under Parts B and Parts D, depending on the type of immunity or exposure. Most vaccines are covered in Part D, and the Part D plan must include vaccines for most commercial vaccines. The only vaccines covered by Part B are influenza (seasonal flu and H1N1 vaccine), pneumonia, hepatitis B and Covid-19. Part B also covers vaccines as treatments for acute exposure, such as tetanus shots after stepping on rusty nails (while Part D will cover conventional tetanus boosters).
To avoid billing issues and surprise fees, please contact your healthcare provider or pharmacy in advance to make sure they can charge your Part D directly.
To avoid billing issues and surprise fees, please contact your healthcare provider or pharmacy in advance to make sure they can charge your Part D directly. If the vaccine is new and has not been added to the planned recipe, you or your representative can request insurance through the recipe exception.
Recent policies that impact vaccine coverage
Starting from 2023, all vaccines covered by Part D are free beneficiaries due to prescription drug provisions under the Inflation Reduction Act. As a result, conventional shingles, TDAP (tetanus, diphtheria and whooping cough) and RSV (respiratory Comprehensive Virus) vaccines are new and cost-free for those participating in Medicare Part D.
Earlier this year, the Supreme Court’s ruling in Kennedy v. Bradwood retained the need for preventive services under the requirements of the Affordable Care Act (ACA). The decision confirms the authority of the U.S. Preventive Services Task Force (USPSTF) to propose recommendations on services that must be covered by the ACA program and to allow immunization coverage to remain the same.
Opposition and politicization of scientific expertise continue to pose a threat to vaccination and research.
However, opposition to scientific expertise and politicization of doubts – from arguments against the authority of the USPSTF, pose a threat to vaccination and research. Affordable immunizations, especially for older people, are essential to reduce necessary care and improve long-term health outcomes.
During the National Immunization Awareness Month, Medicare Rights encourage community members to understand their vaccine eligibility and to stay up to date on immunizations.
Visit Medicare Interactive to learn more about Medicare coverage for vaccines and immunizations.
