Medicare is a program that provides health insurance for older adults and people with disabilities or chronic health conditions. The program is open to all U.S. citizens and permanent residents who have lived in the country for at least five years, are 65 or older, or are under 65 but have been disabled for at least two years.
The Medicare program has several parts, including Part A (hospital insurance), Part B (supplemental medical insurance), and Part D (prescription drug coverage). It also covers some services not covered by private health insurance plans, such as home health care and hospice care.
This article will cover what vaccines Medicare covers and which ones you may be responsible for paying for depending on your age.
The Division of Medicare Cover
Medicare is subdivided into two major categories;
Medicare Part B
Medicare Part B covers several vaccines that are recommended by the Centers for Disease Control and Prevention (CDC), as well as other vaccines that are approved by the Food and Drug Administration (FDA). The following are some of the vaccines covered by Medicare Part B:
- Hepatitis A vaccine: This vaccine helps protect against a virus that causes hepatitis A. The hepatitis A virus can cause a mild illness or lead to liver failure, liver cancer, and death. The vaccine is given in two doses six months apart.
- Measles, mumps, rubella (MMR) vaccine: This vaccine helps protect against three common childhood diseases—measles (rubella), mumps, and rubella (German measles). It is usually given in two doses—the first at 12 through 15 months of age and the second at 4 through 6 years of age.
- Influenza (flu) vaccine: The flu shot protects against two types of influenza viruses—types A and B—that are spread by coughs or sneezes from infected people during flu season (from fall through spring). It is recommended that everyone get an annual flu shot because it can reduce the risk of getting sick from the flu and prevent serious complications from occurring if you do get sick from the flu. People at high risk for complications from influenza should get vaccinated every year before flu season begins as well as the aging individuals.
- Hepatitis B vaccine: This vaccine helps protect against the hepatitis B virus, which can cause serious health problems if left untreated.
- Pneumococcal pneumonia vaccine is given in two doses, one at least two weeks apart and three months after the first dose (if still needed). The second dose must be received by April of the following year to remain covered. Medicare Part B covers all adults over 65 years old and most other high-risk groups, including people with diabetes, chronic lung diseases, heart disease, and kidney failure.
- Covid-19: Coverage for Covid-19 depends on your age and your health. If you’re 65 or older, Medicare Part B covers the Covid-19 vaccine if you have a high risk of getting infected. It includes people who live in nursing homes or other long-term care facilities or people who have chronic medical conditions that make it more likely for them to contract the virus.
Medicare Part D
Medicare Part D covers the following vaccines:
- Chickenpox (varicella): This vaccine is most often recommended for children between the ages of 12 months and 18 years, but it can be given to people over 60 years of age who have never had chicken pox. The vaccine is also recommended for people with weakened immune systems who cannot be vaccinated because they are undergoing cancer treatment or have a weak immune system due to an organ transplant.
- Tdap (tetanus, diphtheria, and pertussis or whooping cough): This vaccine is recommended for all adults over 65 who have not previously received a Tdap booster shot and those between 19 and 64 who have never been vaccinated against pertussis (whooping cough).
- Shingles vaccine: People over 60 should receive this vaccine if they have not yet been vaccinated against shingles (herpes zoster). The shingles vaccine may also be recommended for people between 50 and 59 years old if they have risk factors for developing shingles later in life (such as chronic pain or skin problems).
- Meningococcal (meningitis): This vaccine protects against meningitis caused by serogroups B, C, Y, and W-135 bacteria and is recommended.
How Vaccines Works
Vaccines are a type of medicine that helps your body build immunity to certain diseases. Vaccines contain inactivated or killed germs, which means they won’t cause you to get sick if you get them.
When you get vaccinated, your body will recognize the germs and make antibodies to fight them. The next time your body comes into contact with that germ, it will have the ability to fight it off before it causes any problems.
It is why getting vaccinated is so important; it protects your health before you’re exposed to a disease and helps prevent you from getting sick again in the future.
Medicare Cover Payment
Medicare Part B covers vaccines for some diseases, but not all for free. If you want to get a vaccine that Medicare doesn’t cover, you’ll have to pay for it yourself.
If you don’t have the money to pay for the vaccine, there are other options: you can see if your doctor’s office or pharmacy offers a discount program or payment plan. If they don’t, consider seeing if there is a community health center near you that offers these services.
Medicare Part D plans vary by provider and location; some offer more coverage than others. The cost of vaccines also depends on where you get them; at a pharmacy or during an office visit with your doctor.
The Bottom Line
Medicare is a necessity, especially for the old. It’s the only way many people can afford health insurance, providing significant protection against medical expenses. But did you know that Medicare has gotten better at covering your vaccines?
Medicare now covers a wide range of vaccinations, including hepatitis A and B, influenza, meningitis, tetanus and pertussis, measles, and mumps. If you’re eligible for Medicare Part B, you can also get certain vaccines without paying any copay or coinsurance fees. It can help keep your costs down, and it also means that you’ll be protected from these dangerous diseases.
If you’re on Medicare and considering getting vaccinated against the next pandemic (which could very well be covid-19), consider this. The CDC says that “vaccination is one of the best ways to protect yourself against the disease.” So, for individuals over 65 years, CDC has a vaccination schedule to help them out.
