Do Medicare and Medicaid fully cover most vaccines? Yes. Medicare and Medicaid cover many preventive vaccines recommended for adults by the Advisory Committee on Immunization Practices (ACIP), often with no out-of-pocket cost for eligible beneficiaries. Medicare Part B covers vaccines such as influenza (flu), COVID-19, and pneumococcal vaccines, while Part D covers other recommended vaccines, including shingles, RSV, and Tdap. Medicaid programs generally cover ACIP-recommended adult vaccines without cost-sharing for most beneficiaries.

Medicare Vaccine Coverage at a Glance

Learn which vaccinations are fully covered by Medicare and Medicaid and which ones are recommended for older adults.

Note: If you have Medicare Part B, you generally pay no out-of-pocket costs for Part B-covered vaccines when they're administered by a provider that accepts Medicare assignment. Medicare Part D covers ACIP-recommended adult vaccines that aren't covered by Part B. You pay no out-of-pocket costs for these vaccines when they're covered by your Part D plan. Medicaid also covers ACIP-recommended adult vaccines for most beneficiaries without cost-sharing.

Which Medicare plans cover vaccines?

Most preventive vaccines are covered by Medicare Part B or Medicare Part D. Part B covers flu, COVID-19, pneumococcal, and hepatitis B for eligible people.

Part D covers recommended adult vaccines such as shingles (Shingrix), RSV, and Tdap (tetanus, diphtheria, and pertussis, also known as whooping cough).

How to get a $0 vaccine with Medicare

1. Check whether your vaccine is covered by Part B or Part D.
2. Use a participating provider or pharmacy that can bill your Medicare coverage correctly.
3. Before getting vaccinated, confirm that the provider accepts your plan and ask whether you'll owe anything.
4. If you have Medicare Advantage, check your plan's network requirements.

Which vaccines do Medicare Part B and Part D cover?

Part B covers vaccines and vaccine administration for:

• Flu shots
• Pneumococcal shots
• COVID-19
• Hepatitis B (for people at medium and high risk)
• Certain reasonable and necessary vaccines to treat an injury or exposure to a disease

Part D-covered vaccines include those for:

• Tdap
• RSV
• Shingles

Medicare Part D covers all adult vaccines recommended by ACIP with no cost-sharing when they are included under a beneficiary’s plan, except those vaccines covered by Part B. If you do not have Part D or a Medicare Advantage plan with prescription drug coverage, you could face out-of-pocket costs for certain vaccines.

If you have Medicare Part B, the pharmacy or provider administering the vaccine must accept Medicare assignment. If you have Part D, you must generally receive the vaccine from a pharmacy or provider within your plan’s network.

Failure to meet plan requirements means you may get billed for the service—or you may have to pay up front and request reimbursement later.

Frequently asked questions (FAQ)

Are vaccines free with Medicare?
Yes. Many recommended vaccines are free with Medicare. Medicare Part B covers certain vaccines with no deductible or coinsurance, while Medicare Part D covers ACIP-recommended adult vaccines with no cost-sharing. However, you generally need to use an appropriate participating or in-network provider or pharmacy to avoid being billed.

Are vaccines free with Medicaid?
Yes. Medicaid covers most ACIP-recommended adult vaccines without cost-sharing for eligible beneficiaries. Coverage requirements can vary by Medicaid eligibility group and state, so check with your state Medicaid program or health plan for details.

Does Medicare cover the COVID-19 vaccine?
Yes. Medicare and Medicaid continue to cover recommended COVID-19 vaccines at no cost to eligible beneficiaries.

The Centers for Disease Control and Prevention (CDC) recommends that for everyone age 6 months and older, COVID vaccination should be a choice made with a health care provider.

For adults who are age 65+ or living with conditions like diabetes or heart disease, vaccines continue to offer strong, reliable protection against severe illness, hospitalization, and death.

“At NCOA, we encourage older adults to speak with their doctor or pharmacist about their health risks and to stay current with COVID, flu, and RSV vaccines,” says Dorothea Vafiadis, NCOA Senior Strategist for Healthy Aging. “The evidence is clear that vaccines save lives.”

Does Medicare cover Shingrix?
Yes. Medicare Part D covers Shingrix at no cost when it’s included in your plan’s network. Shingrix is the only vaccine used in the U.S. to help prevent shingles. This viral infection, which causes a painful skin rash, affects about 1 out of 3 people in the U.S. And your risk of getting shingles—and complications from shingles—increases with age.¹

CDC recommends healthy adults age 50 and older get two doses of Shingrix separated by two to six months. Vaccination is also recommended for some adults age 19 years and older who have compromised immune systems. People who are immunocompromised can receive their second dose of Shingrix one to two months after the first dose.

The Shingrix vaccine is more than 90% effective at keeping you from getting shingles and from developing long-term nerve pain.¹

Does Medicare cover the RSV vaccine?
Yes. Medicare Part D covers the respiratory syncytial virus (RSV) vaccine for adults who meet ACIP recommendations. RSV is a common respiratory virus that affects the lungs and breathing passageways. It typically causes mild, cold-like symptoms. Like COVID and the flu, RSV is highly contagious.

While most people recover from RSV within a week or two, some are more likely to develop serious illness and complications. This includes older adults and infants age six months or younger. RSV symptoms usually start within four to six days after getting infected with the virus and include fever, congestion, runny nose, sore throat, and a barking cough.

✅ Important: Since coverage for vaccines varies depending on the types of Medicare coverage you have, check with your Medicare plan to learn the specific details of what’s covered.

Does Medicaid cover the flu vaccine?
Yes. Medicaid covers the flu vaccine at no cost for most beneficiaries since it’s recommended by ACIP. Getting a flu shot each year is one of the best ways to protect yourself from severe illness, especially as you get older.

Does Medicaid cover Shingrix?
Yes. The shingles vaccine (Shingrix) is fully covered with no out-of-pocket costs for most eligible adults with Medicaid. If you're age 50 or older—or have certain conditions that weaken your immune system—talk to your doctor about whether it's time to get vaccinated.

Does Medicaid cover the RSV vaccine?
​​​​​​​Yes. ​​​​​​​​​​​​​​The RSV vaccine is 100% covered for most Medicaid beneficiaries who meet current CDC guidelines. If you're age 75 or older, or you're 50 to 74 and at higher risk for severe RSV disease, ask your doctor or pharmacist whether the vaccine is right for you.

Talk to your doctor about which vaccines you need

Be sure to discuss your immunization needs with your health care provider, since recommendations can vary depending on your overall health and underlying medical conditions. To learn more about the vaccinations you may need to stay healthy, visit the CDC website.

In the past, many seniors have gone without life-saving vaccines, like shingles and Tdap, because their budgets couldn’t stretch to cover out-of-pocket expenses. Thanks to federal legislation that eliminated out-of-pocket costs for many recommended vaccines, Medicare and Medicaid now make it easier for eligible adults to stay up to date and protect their health.

Source

1. Centers for Disease Control and Prevention. About Shingles (Herpes Zoster). Found on the internet at https://www.cdc.gov/shingles/multimedia/shringrix-50-older.html