Does Medicare cover it?
Does Medicare cover the shingles vaccine?
Yes, through Part D. If you have a Medicare drug plan, the shingles vaccine costs you nothing, with no deductible and no copayment. Original Medicare, Parts A and B, does not pay for it. The tool shows both situations; without Part D, enter the price you were quoted per dose.
What this service costs you
The shingles vaccine is a Part D benefit, not a Part B one, and that single fact decides what you pay. With a Medicare drug plan you pay $0: Part D covers every adult vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) that Part B does not cover, and your plan may not charge a copayment or apply its deductible to those vaccines. The shingles vaccine protects against the varicella-zoster virus, which causes a painful skin rash and sometimes serious complications such as long-lasting pain. If you have only Original Medicare, meaning Parts A and B without a drug plan, Medicare does not pay for the vaccine, and the price charged is yours. The $283 Part B deductible and the 20% coinsurance play no role in either case, and a Medigap policy does not help, since it fills gaps in Part A and Part B costs only. The same no-cost rule under Part D applies to other ACIP-recommended adult vaccines, including those for respiratory syncytial virus (RSV), whooping cough and measles. The tool below compares both cases; without Part D, type the price per dose you were quoted to see the total.
Costs computed by Radif Partners · Editorial policy · How the costs are calculated
One vaccine, two very different bills
For most services on this site, the cost question is about percentages: the deductible, then 20%. The shingles vaccine works differently. It is covered by Medicare drug coverage, Part D, and not by Part B. With Part D the answer is $0. Without it, Original Medicare pays nothing toward the vaccine. There is no middle case in which Medicare pays part of it.
| Your coverage | Who pays | Your cost |
|---|---|---|
| Original Medicare with a Part D drug plan | The Part D plan, in full | $0 |
| Original Medicare without a drug plan | Nobody in Medicare | Price charged |
| Original Medicare with Medigap, no drug plan | Medigap does not cover it | Price charged |
What the Part D rule guarantees
Medicare's text is short and leaves little room: Part D covers all adult vaccines recommended by ACIP that are not covered under Part B, and your Part D plan will not charge a copayment or apply a deductible for them. That means the vaccine is free even in January, before you have spent anything else on prescriptions, whatever copays your plan charges for other prescriptions.
The same rule reaches beyond shingles. Medicare cites the vaccines for respiratory syncytial virus, for whooping cough and for measles among the ACIP-recommended adult vaccines that Part D covers at no cost. If you are planning several vaccines, the same answer applies to each of them.
If you have no Medicare drug plan
Parts A and B alone do not cover the shingles vaccine. In that case the price charged by the provider is what you pay, and the tool takes that price per dose to show the total. Medigap does not change the outcome, because the policies sold under that name only share Part A and Part B costs. Other drug coverage you may hold, through an employer for example, may pay for it; check with that plan.
The amount you are asked to pay depends on factors Medicare lists for any service: other insurance you may have, how much the provider charges, whether the provider accepts assignment, the type of facility and where you get the vaccine. Asking for the price before the appointment avoids a surprise at the counter.
A year of what Medicare leaves out
You pay
$0
| Billed | $0 |
| Original Medicare pays | $0 |
| Allowances | $0 |
What the vaccine is for
Medicare describes shingles vaccines as protection against the varicella-zoster virus, which causes a painful skin rash and sometimes serious complications, long-term pain among them. Whether and when to be vaccinated is a medical question for your doctor; this page covers only the cost.
Where the vaccine sits among preventive services
Part B covers many preventive services at no cost when the provider accepts assignment, such as screening colonoscopies or screening mammograms. The shingles vaccine is the exception that surprises people, because it looks like a preventive service but is paid by the drug plan. If you are comparing Part D plans during an enrollment period, its cost will be the same in all of them; the difference between plans lies elsewhere.