Which Vaccines Does Medicare Cover? Flu, Shingles, RSV, and More

The Basic Split: Part B and Part D

Medicare doesn’t have one vaccine benefit. It has two, and the dividing line follows a historical logic that’s easy to forget but important to remember:

• Part B (medical insurance) covers a short list of vaccines named in the law, plus vaccines needed because of an injury or exposure.
• Part D (prescription drug coverage) covers other vaccines that are recommended for adults by the Centers for Disease Control and Prevention’s advisory committee.

For both, the cost to you has been reduced to nothing for the routine recommended vaccines. Part B vaccines typically cost you $0. Since the Inflation Reduction Act took effect in 2023, Part D plans can’t charge cost-sharing for recommended adult vaccines either, and you don’t have to meet a deductible first.

That sounds simple, but the practical issue is who bills and where. Part B vaccines are billed to Medicare, so almost any doctor’s office or pharmacy that accepts Medicare can give them. Part D vaccines are billed to your drug plan, and the plan has pharmacy networks.

Which Part Covers Which Vaccine

Vaccine	Covered under	Typical cost to you
Flu	Part B	$0
Pneumococcal	Part B	$0
COVID-19	Part B	$0
Shingles	Part D	$0 at an in-network pharmacy
RSV	Part D	$0 at an in-network pharmacy
Tdap and Td boosters	Part D	$0 at an in-network pharmacy

Vaccines Covered Under Part B

Part B covers these vaccines, generally at no cost to you when the provider accepts assignment:

• Flu (influenza) shot: Usually covered once per flu season. Medicare Part B covers the flu vaccines recommended for people 65 and older, including higher-dose and adjuvanted versions that are designed to produce a stronger response in older adults.
• Pneumococcal vaccines: These protect against pneumococcal disease, which includes pneumonia and bloodstream infections. Medicare covers the recommended pneumococcal vaccines for eligible adults. The CDC’s recommendations for which pneumococcal vaccine to receive and when have changed over time, so ask your doctor or pharmacist which applies to you.
• Hepatitis B vaccine: Covered when you meet at least one of Medicare’s criteria. According to Medicare.gov, these include never having completed the vaccine series, not knowing your vaccination history, or having a health condition or situation that raises your risk, such as diabetes or end-stage renal disease. Ask your provider whether you qualify.
• COVID-19 vaccine: Covered under Part B, with no cost to you.
• Vaccines related to an injury or exposure: A tetanus booster after a cut or wound, or rabies treatment after an animal bite, is covered under Part B when it’s directly related to treating the injury or a direct exposure, according to CMS’s Medicare Benefit Policy Manual.

Since Part B handles these, you can usually get them at your doctor’s office, a pharmacy, or a clinic that bills Medicare. You’ll need your red, white, and blue Medicare card, or your Medicare Advantage plan card if you have an Advantage plan.

Vaccines Covered Under Part D

Part D covers the rest of the commonly recommended adult vaccines, including:

• Shingles vaccine (Shingrix): A two-dose series. People with Part D generally pay nothing when the vaccine is covered under the plan.
• RSV vaccine: Respiratory syncytial virus can cause serious illness in older adults. Medicare.gov describes the vaccine as for adults 75 and older and for certain adults ages 50 to 74 who are at higher risk of severe RSV. Guidance on this has evolved, so check with your doctor about the current recommendation for your age and health.
• Tdap and Td: Tetanus, diphtheria, and pertussis boosters, when given as routine vaccination rather than in response to an injury.
• Other routine adult vaccines that the CDC recommends and that aren’t covered by Part B.

Part D’s no-cost rule follows the vaccines that the CDC’s advisory committee recommends, so if a recommendation changes, your coverage for that vaccine can change with it. The important thing is that these depend on having Part D coverage. If you have Original Medicare and no drug plan, you generally pay the full price for these vaccines, which can be a significant amount per dose for some of them. People sometimes skip the drug plan because they take few medications, then discover that vaccine costs are one reason it mattered. Our overview of Medicare Part D explains how coverage and penalties work.

Where You Get the Shot Matters for Part D Vaccines

This is the single most practical tip in this post. Because Part D vaccines are billed to your drug plan, the safest place to get one is an in-network pharmacy. When you get a Part D vaccine at a pharmacy that participates in your plan’s network, the pharmacy bills the plan directly and you pay nothing.

If you get a Part D vaccine at your doctor’s office, however, the office may not be set up to bill your drug plan the way a pharmacy does. In that case you might have to pay upfront and file a claim with your plan to be reimbursed. Federal guidance from CMS says plans can’t charge you cost-sharing on recommended adult vaccines, including when you get them from an out-of-network provider, and can’t pass along the difference between the provider’s price and the plan’s allowed amount. Even so, paying first and waiting for reimbursement is a hassle, and it’s the most common way a “free” vaccine turns into a bill or a headache.

So the rule of thumb is this: for Part B vaccines like the flu shot, any Medicare-accepting provider works. For Part D vaccines like Shingrix, RSV, or Tdap, call your pharmacy first to confirm they’re in-network and have the vaccine in stock, and ask your doctor’s office whether they bill Part D before getting the shot there.

Medicare Advantage and Medigap

Medicare Advantage: Advantage plans must cover everything Original Medicare covers, so the Part B vaccines are covered. If your plan includes prescription drug coverage, the Part D vaccines are covered under that portion, with the same no-cost-sharing rule for recommended adult vaccines. Follow your plan’s network rules: some plans want you to use particular pharmacies or providers. If your Advantage plan has no drug coverage, the Part D vaccines wouldn’t be covered.

Medigap: Medicare Supplement plans cover cost-sharing for Medicare-approved services. They don’t cover prescription drugs, so they don’t pay for Part D vaccines, and since the Part B vaccines already have no cost-sharing, there’s nothing for Medigap to add. If you have a plan like Plan G, you’d still want a stand-alone Part D plan for the shingles, RSV, and Tdap vaccines.

Travel Vaccines

Vaccines mostly for travel, such as those for yellow fever, typhoid, or Japanese encephalitis, are generally not covered by Original Medicare. Some Part D plans may cover certain travel vaccines, but coverage varies by plan and by vaccine, and the no-cost-sharing rule applies to vaccines that the CDC’s advisory committee recommends for routine adult use, which travel vaccines usually aren’t. If you’re planning international travel, ask your plan before you book a travel clinic appointment.

Military Retirees and Veterans

Military retirees on TRICARE For Life and veterans enrolled in VA health care have additional ways to get vaccines. TRICARE For Life coordinates with Medicare, and the TRICARE Pharmacy Program offers its own vaccine access, while VA clinics provide vaccines to enrolled veterans. The specifics depend on the program, so check with them. We’re an independent agency, not affiliated with the VA, TRICARE, or the Department of Defense. Our guide to Medicare and TRICARE For Life explains how the benefits coordinate.

A Practical Vaccine Checklist

If you’re trying to get up to date, here’s a simple way to work through it:

• Ask your doctor or pharmacist which vaccines you’re due for. The recommendations depend on age, health conditions, and what you’ve had before.
• Sort them by Part B or Part D. Flu, COVID-19, pneumococcal, and qualifying hepatitis B are Part B. Shingles, RSV, and routine Tdap are Part D.
• Use an in-network pharmacy for Part D vaccines. Call ahead to confirm the plan will be billed and the vaccine is available.
• Bring your cards. Have your Medicare card, and your drug plan or Advantage card if you have one.
• Keep records. Ask for a copy of your vaccination record, and check it against your state immunization registry if you can. It helps if you change doctors.
• Check with your plan if the pharmacy says there’s a charge. For recommended adult vaccines on Part D, a charge is a red flag. It may be a network issue or a billing error that can be corrected.

If you’ve paid for a vaccine that should have been free, ask the pharmacy or doctor to rebill it, and file a reimbursement claim with your plan if needed. If it keeps happening, our open enrollment guide is a good starting point for reviewing whether your drug plan fits.

Timing: Flu Season and Open Enrollment

Flu vaccines are usually available in late summer and early fall, and getting one by the end of October is a common recommendation, though your doctor can advise on timing for you. That timing overlaps with the Annual Enrollment Period, October 15 through December 7, when you can change drug plans. If you’ve been paying out of pocket for vaccines, or if you’re unsure whether you have Part D at all, this is the time to look. Part D coverage generally starts January 1 when you join during open enrollment.

Frequently Asked Questions

Does Medicare cover the flu shot?

Yes. Part B covers one flu shot per flu season, with no cost to you if the provider accepts assignment. That includes the higher-dose and adjuvanted vaccines recommended for older adults.

Does Medicare cover the shingles vaccine?

Yes, under Part D. If you have a Part D plan, you generally pay nothing for Shingrix, but it’s best to get it at an in-network pharmacy. Original Medicare without Part D doesn’t cover it.

Does Medicare cover the RSV vaccine?

Yes, under Part D, which covers the RSV vaccine at no cost to you if you have Part D. Medicare.gov describes it as for adults 75 and older and certain adults ages 50 to 74 at higher risk. Ask your doctor whether you’re in a recommended group, since guidance has changed.

Is the pneumonia vaccine covered by Medicare?

Yes. Part B covers the recommended pneumococcal vaccines for eligible adults, usually at no cost to you.

Why was I charged for a vaccine at my doctor’s office?

If the vaccine is a Part D vaccine, the doctor’s office may not be able to bill your drug plan, which can leave you paying upfront and filing for reimbursement (CMS guidance says your plan can’t charge you cost-sharing for recommended adult vaccines). A pharmacy in your plan’s network is usually the better choice.

Does Medigap cover vaccines?

Medigap doesn’t cover Part D vaccines. Part B vaccines already have no cost-sharing, so Medigap has nothing to add there.