Navigating Vaccine Coverage for Seniors With Medicare Changes

Getting the right vaccinations can help your older clients stay healthy and active longer.

As individuals age, their need for protective measures against certain infectious diseases, including shingles and respiratory syncytial virus , major cause of pneumonia, becomes increasingly important.

George, a 70-year-old retired social worker, sent us a question about this topic.

The Question

Under the Inflation Reduction Act, are vaccines like the shingles vaccine now covered by Medicare at no cost? If so, how can I get them?

The Answer

Yes, the Inflation Reduction Act helped Medicare beneficiaries by providing coverage of eligible vaccines with no out-of-pocket costs for the beneficiaries. The list of covered vaccines includes the vaccines against shingles, RSV and pneumonia.

This legislative change marks an important shift toward enhancing preventive health measures for seniors, promoting a proactive approach to health care.

Which Plan Covers What

Through Original Medicare, Part B provides shots for seasonal flu, pneumonia and COVID-19; as well as hepatitis B vaccines for high-risk individuals, plus tetanus shots for beneficiaries who are injured.

Medicare Part D prescription drug plans cover the shingles, Tdap, RSV, hepatitis and meningococcal vaccines.

For those with Medicare Advantage plans that encompass prescription drug coverage, the same protections apply.

More to Consider

Covered vaccines: The Inflation Reduction Act offers certain recommended preventive vaccines free of charge for those beneficiaries enrolled in a Medicare Part D plan.

Any vaccine recommended by the Advisory Committee on Immunization Practices, or ACIP, that is covered under Medicare Part D is now available at no cost to the patient.

Access and implementation: Medicare beneficiaries can now receive vaccines at no cost at pharmacies and health care providers that accept Medicare.

Broader impacts: This change not only benefits individual seniors by protecting them against specific diseases but also contributes to the broader public health goal of disease prevention. By increasing vaccination rates among seniors, Medicare is helping to reduce the prevalence and impact of infectious diseases across the population.

Consulting health care providers: Seniors interested in taking advantage of this new benefit should consult with their healthcare providers to understand which vaccines are recommended for them and how to receive them under Medicare coverage.

This development is a key component of a broader strategy to enhance healthcare outcomes for the aging population, providing peace of mind and fostering a healthier community overall.

Bethany Cissell is director of business development and a Medicare expert at Allsup, a national disability representation provider based in Belleville, Illinois.