Vaccine Coverage in 2023

The coverage for a vaccine depends on the part of Medicare under which it falls. 

Part B, medical insurance, covers most vaccines that Medicare beneficiaries need. There is no copayment for those that every Medicare beneficiary should get, specifically:

  • Covid vaccinations (no matter how many shots you get)
  • Prevnar 13® and Pneumovax® 23 (pneumonia vaccines), and
  • The Flu Vaccine.

Those who chose Original Medicare can get the vaccine from any doctor or pharmacy that accepts Medicare assignment. Medicare Advantage plan members should visit a doctor or pharmacy in the plan’s network. No matter the type of Medicare you have, there is no deductible, copayment or coinsurance.
Part D, prescription drug coverage, covers the vaccines that Part B doesn’t. Probably the two most important for seniors would be the Shingrix and DTaP (diphtheria, tetanus, and pertussis) vaccinations. Even though these are just as important as Part B vaccines, Part D vaccines have been treated differently when it comes to cost. They are subject to the drug plan deductible and carry hefty copayments. The copayment for DTaP is around from $70 and for Shingrix, almost $200 an injection.

That will change as of January 1, 2023. Just as with the flu, Covid and pneumonia vaccinations, Part D vaccines will not be subject to a deductible and there will be no copayment. Keep these points in mind: 
1) The best way to get these vaccinations is to visit a pharmacy that’s in your Part D drug plan’s network.