Questions regarding vaccines and how to get them covered through Medicare are quite a common concern.
First of all it’s important to understand that all vaccines that are commercially available can be covered under Medicare Part B or the Part D Prescription Drug Plan. However, the
coverage depends on the vaccine and circumstances.
What vaccines are covered under Medicare Part B?
Under Medicare Part B, a doctor’s office or an approved Medicare supplier can administer the two type of vaccines mentioned below:-
Influenza Virus Vaccine – The Medicare Part B will cover 100% of the costs of one flu shot per flu season. The coverage is subject to the vaccine provider accepting Medicare.
Pneumonia Vaccines – The Medicare Part B will cover 100% of the cost of both pneumococcal vaccines, when they are administered at least 12 months apart.
What vaccines are covered under Medicare Part D Prescription Drug Plan?
The Medicare Part D Prescription Drug Plan will cover vaccines that are administered by pharmacies. These vaccines include:-
Hepatitis B Vaccine – For those patients that are at a high and immediate risk, Medicare Part D will cover 100% of the cost for a series of shots if the provider accepts Medicare. Please note that you are considered to be at risk if you have End-Stage Renal Disease (ESRD), hemophilia, or diabetes. You’re also considered to be at risk if you live with an individual who has Hepatitis B or are employed in an environment that requires frequent contact with blood or bodily fluids.
Tetanus Vaccine – If the vaccine is a direct treatment of an injury, then it will be covered by the Medicare Part B. If the vaccine is not for direct treatment of an injury, a booster shot will be recommended every 10 year and will be covered under Part D.
It’s important to keep in mind that your Medicare Part D Prescription Drug Plan will generally cover all the vaccines that are commercially available and those mentioned above. However, coverage of some of the vaccines may be subject to your doctor accepting Medicare. Although the Medicare Part D Prescription Drug Plan will cover vaccines that are commercially available, that does not mean that a co-payment will not be required.
Contact us if you want to know more about which vaccines are covered by your insurance plan.
We work as Independent Insurance Brokers, and have been appointed by many of the major insurance carriers. We can help you find the best policy for your individual situation. We work with clients in Winchester, VA, Martinsburg, WV, and Charles Town, WV.
For more details, please feel welcomed to contact us today at (540) 662-4432, and talk to one of our Insurance agents or simply visit our website medicaretrustedagents.com to obtain more information.