Medicare Part D will fully cover the shingles vaccine in 2023

Many Medicare Part D prescription drug plans now require at least a copay for the shingles vaccine. But that will change as of January 1, 2023.

The Centers for Disease Control and Prevention (CDC) estimates that about 1 in 3 people in the United States will develop shingles in their lifetime.

Shingles, a reactivated form of the chickenpox virus, often causes an itchy, painful rash on the body that can last for months or even years. Anyone who has had chickenpox can get shingles, including children, but older people or people with weakened immune systems are at higher risk.

In a 2019 report to Congress, the Medicare Payments Advisory Committee found that the cost of the shingles vaccine — which could be more than $400 for the two required doses if a Medicare recipient doesn’t meet the deductible their exclusions – “may pose a barrier to vaccination.”

VERIFY reader Patricia recently messaged the group to ask if Medicare will start paying for the shingles vaccine in 2023.


Will the shingles vaccine be free for Medicare recipients in 2023?



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Yes, the shingles vaccine will be free for people receiving Medicare in 2023, if they purchased optional Part D prescription drug coverage from a private insurer.

Many Medicare Advantage plans offered by private companies also include Part D coverage.


The shingles vaccine is not guaranteed to be free for people receiving Medicare right now. According to the insurance company Humana, the cost can depend on your plan, the type of vaccine you get, and where you get it.

Most Medicare plans that offer prescription drug coverage still require a copay for vaccines that can vary widely in cost based on which plan you have. Humana explains that people with Medicare drug coverage may also have to pay the full price of the shingles vaccine if they don’t meet the deductible for the year.

But that will change as of January 2023 due to the Inflation Reduction Act.

Medicare is federal health insurance for anyone age 65 or older and certain people under age 65 with certain disabilities or medical conditions. It consists of four parts: A, B, C and D. You can read more about the content of each section here.

Medicare Part D, which is voluntary, provides coverage for prescription drugs and immunizations. Medicare participants can purchase Part D coverage from a private insurance company, or this coverage can be included as part of Medicare Advantage (Part C) plans offered by private companies. .

Parts A and B alone do not cover all prescriptions and vaccines.

The Inflation Reduction Act, passed by Congress in 2022, includes prescription drug and vaccine provisions that have an impact on people receiving Medicare Part D.

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One of those provisions requires insurance companies that provide Medicare Part D prescription drug coverage to cover the full cost of adult vaccines issued by the CDC Advisory Committee on Immunization Practices (ACIP). recommendations starting January 1, 2023. That includes the shingles vaccine.

This means that people with Medicare Part D will be “out of pocket” for the shingles vaccine and other vaccines recommended by ACIP, the Centers for Medicare and Medicaid Services said in a news release. information about the Inflation Reduction Act.

The Kaiser Family Foundation notes that about 1 in 4 people who receive Medicare do not have optional prescription drug coverage, meaning they will not receive benefit changes related to prescription drugs and possible vaccines. in the Inflation Reduction Act.

People who meet certain income requirements can get help paying for Medicare Part D through the government’s “Extra Help” program.

Uninsured people can also get free or low-cost vaccines through their state health department or community health center.

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