What is Shingles?
Most people over the age of 50 know about Shingles, because they’ve heard about how awful it can be from a friend. In case you didn’t know, Shingles is a viral infection (the same virus that causes chickenpox!) that causes a painful blistery rash. Anyone who has had chickenpox is at risk of getting Shingles. About 1 in 3 people in the United States will develop Shingles in their life. Your risk of having Shingles increases as you get older or if you have a weakened immune system. Most people who have Shingles only have it one time. However, you can have Shingles more than once. The rash commonly appears on the torso, although it can occur anywhere on your body. The pain can be intense, which brings us to our real topic today: the Shingles vaccine.
Does Medicare cover the Shingles vaccine?
The short answer is YES! Medicare does cover the Shingles vaccine. The cost of the Shingles vaccine used to vary depending on your Medicare plan, but all that changed thanks to the Inflation Reduction Act. As of January 1, 2023, vaccines for Shingles and Tdap are now free under Medicare Part D.
Original Medicare which is Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance), does not cover the shingles vaccination. The Shingles vaccine is covered under your Medicare prescription drug plan (Part D). This is why it is important to enroll in Medicare Part D, even if you don't have prescription drugs. If you don't have a prescription drug plan, the full price for two doses of the Shingles vaccine (known as Shingrix) is $370 as of January 2023. The most effective method to prevent Shingles is to have two doses of the vaccine two to six months apart.
The Shingles Vaccine is Free with Medicare Part D
All Medicare prescription drug plans fully cover the Shingles vaccine, even if you have not met your plan's deductible. There is no copay, and the Shingles vaccine is free for all seniors with a Medicare prescription drug plan. It does not depend on which drug plan you have!
What Else did the Inflation Reduction Act Change?
Medicare plans and regulations are continually changing. The Inflation Reduction Act is just one example of a piece of legislation that has real impact for Medicare participants. People with Medicare benefit from lower prescription drug costs and a redesigned prescription drug program. Just a few of the benefits include certain types of insulin at $35 a month, access to adult vaccines without cost-sharing, and a yearly cap on out-of-pocket prescription drug costs in Medicare.
What Vaccines are Covered with Medicare?
Vaccines are typically covered under Medicare Parts B and D. Part B vaccines have been cost-free (depending on what Medicare plan you are enrolled in) since before the Inflation Reduction Act, and those include the annual flu vaccines, pneumococcal shots, and Covid-19 vaccines.
For Part D vaccines, including Shingles and Tdap, people have usually had to share the cost through co-pays. Part D vaccines are now cost-free.
Make Sure You have a Part D Plan!
At Jbird Insurance Group, we are invested in your financial and physical well-being. Medicare regulations change all the time! Now is a great time to make sure you have a trusted Medicare professional who can help you understand your benefits and find appropriate plan options for your budget and your health. Don’t put off getting important vaccines like the Shingles shot because you are unsure of any associated costs. Tell your friends; the Shingles shots are now free!
Need help understanding your Medicare plan? Let us help find the right Medicare plan for you!