Staying up to date on recommended vaccines is one of the most powerful ways to protect our health and independence as we age. Adults age 65 and older should receive six key vaccines: flu, shingles, pneumococcal disease, RSV, COVID-19, and hepatitis B (for eligible adults). Medicare covers these recommended vaccines at no cost when you meet your plan’s requirements.

Read on to learn who should get each vaccine, when to get it, and how Medicare covers it.

What vaccines do seniors need?

Below is a list of six recommended vaccines for older adults that are 100% covered by either original Medicare or Medicare Part D (standalone or as part of a Medicare Advantage plan).

1. Flu vaccine

Who should get the flu vaccine?
According to current Centers for Disease Control and Prevention (CDC) recommendations, everyone age 6 months and older should get a flu vaccine every year, with very few exceptions. A higher-dose version of the flu shot is available specifically for older adults.

Why is the flu vaccine important for older adults?
Older people, especially the 93% of adults age 65+ who are managing at least one chronic condition, are more likely to develop complications or become hospitalized with the flu. Flu combined with pneumonia—a common acute condition among the aging population—consistently ranks as one of the top 12 causes of death in the U.S.

According to CDC, the flu shot prevents millions of illnesses and doctor's visits each year. Getting the shot doesn’t guarantee you won’t get sick—but it does help lower the risk of severe illness, hospitalization, and complications. That protection matters, even in challenging flu seasons where the vaccine isn’t a perfect match to circulating strains. 

When should get the flu vaccine?
You should get a flu shot annually. Flu season in the U.S. typically peaks between November and March, so aim to get your vaccine in September or October to prevent contracting the flu from a family member, friend, or caregiver during the holidays. It’s important to note that it does take two weeks after getting the shot for your body to build up full immunity. 

Did you miss the prime vaccination window? Flu season can peak as late as February or even March—so as long as the virus is still circulating, it’s not too late to get your yearly flu shot.

How does Medicare cover the flu vaccine?
Medicare Part B covers one flu shot each flu season at no cost when you get it from a provider or pharmacy that accepts Medicare assignment. You don't need a Part D plan to receive this coverage. If you have original Medicare, you must use a physician or health care provider who accepts Medicare. If you have Medicare Advantage, you may have to use an in-network doctor or pharmacy. Contact your plan for details.

2. Shingles vaccine (Shingrix)

Who should get the shingles vaccine?
CDC recommends that healthy adults age 50 years and older get two doses of the vaccine to prevent shingles (Shingrix) separated by two to six months. Vaccination is also recommended for some adults age 19 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. 

Note: Shingrix replaced the prior shingles vaccine Zostavax and has been the only shingles vaccine available in the U.S. since November 2020. If you had the Zostavax vaccine previously, you should still get the Shingrix shot. Talk to your health care provider about the best timing to get Shingrix. 

Why is the shingles vaccine important for older adults?
Age-related decline in immunity can trigger the “reawakening” of the dormant chickenpox virus, according to researchers. One in three adults contracts shingles at some point in their life—the majority of whom are 60 years or older.

The older you are when you get shingles, the more likely you are to have severe side effects, like fever, exhaustion, and loss of appetite. These can lead to malnutrition, physical deterioration, and/or additional infections. Whether you remember having chickenpox as a child or not, you should still talk to your doctor about getting vaccinated.

When should you get the shingles vaccine?
You should get the shingles vaccine as soon as you become eligible; there's no need to wait for a certain time of year to get vaccinated. The shingles shot is given in two doses, usually 2–6 months apart, to help protect against shingles and its complications.

How does Medicare cover the shingles vaccine?
The shingles vaccine is covered under Medicare Part D. If you have Medicare Part D or a Medicare Advantage plan with prescription drug coverage, you should pay nothing out of pocket when you receive this vaccination. You'll typically need to get the vaccine from a pharmacy or provider in your Part D plan's network.

3. Pneumococcal vaccine

Who should get the pneumococcal vaccine?
CDC guidelines recommend pneumococcal vaccination for all adults age 50 and older and for younger adults with certain medical conditions or other risk factors.

There are two main types of pneumococcal vaccines: pneumococcal conjugate vaccines (PCVs) and pneumococcal polysaccharide vaccines (PPSV23). Your health care provider can help determine which pneumococcal vaccine you need based on your age, health, and vaccination history.

Why is the pneumococcal vaccine important for older adults?
Older adults and people with certain underlying conditions are at greater risk for severe pneumococcal-related illness and complications. Pneumococcal disease can cause pneumonia (infection of the lungs), meningitis (infection of the lining of the brain and spinal cord), and bacteremia (infection of the bloodstream), potentially leading to deafness, brain damage, loss of limbs, and even death. Each year, more than 2 million people develop a pneumococcal infection, and about 6,000 die from the disease.¹ 

When should you get the pneumococcal vaccine?
You can get the pneumococcal vaccine any time of year. According to CDC guidance, adults age 50 and older should receive the vaccine. But the timing and number of doses you need depend on your age, health, and vaccination history. Check with your doctor to see if you’ve had either pneumococcal vaccine already.

How does Medicare cover the pneumococcal vaccine?
The pneumococcal vaccine is a cost-free benefit covered by Medicare Part B. If you have Medicare Part B, you must use a physician or health care provider who accepts Medicare. If you have Medicare Advantage, you may have to use an in-network doctor or pharmacy.

4. RSV (respiratory syncytial virus)

Who should get the RSV vaccine?
CDC recommends the single-dose RSV vaccine for all adults age 75 and older and for adults ages 50–74 who are at increased risk for severe RSV disease due to certain chronic medical conditions or other risk factors.

Three vaccines are currently approved by the U.S. Food and Drug Administration (FDA) to help prevent severe RSV in adults: GSK's Arexvy, Moderna's mResvia, and Pfizer's Abrysvo single-dose vaccines. Ask your doctor or pharmacist if the vaccine is right for you.

Why is the RSV vaccine important?
RSV, a common and highly contagious respiratory virus, can cause serious illness in older adults, especially those over 60 or with underlying health conditions like heart or lung disease. The infection can lead to pneumonia, hospitalization, and even death. Getting the RSV vaccine helps reduce the risk of dangerous complications.

When should you get the RSV vaccine?
You can get the RSV vaccine at any time, but late summer or early fall is the best time to get it. Keep in mind the RSV vaccine is not something you need every year. If you already got the shot (even last year), you do not need another one right now.

How does Medicare cover the RSV vaccine?
Medicare covers the RSV vaccine through Medicare Part D. If you have a standalone Part D plan or Medicare Advantage plan with prescription drug coverage, you should pay nothing out of pocket for this shot, but you may have to use an in-network doctor or pharmacy. Contact your plan for details.

If you only have Medicare Part B and do not have Part D or a Medicare Advantage plan that includes prescription drug coverage, Medicare generally does not cover the RSV vaccine. You may have to pay the full cost out of pocket.

5. COVID-19 vaccine

Who should get the COVID vaccine?
For everyone age 6 months and older, CDC recommends that COVID vaccination be an individual decision that’s made with a health care provider. NCOA encourages older adults to talk to their doctor about their personal risks and get vaccinated to protect their health, independence, and quality of life.

Why is the COVID vaccine important?
COVID-19 continues to pose the greatest risk to older adults. From 2022 to 2024, adults age 65 and older represented less than one-fifth of the U.S. population but accounted for nearly half of all COVID-19 cases, two-thirds of hospitalizations, and more than 80% of deaths.²

Due to a natural decline in immunity as we age, older adults face a greater risk of getting infected with COVID and developing severe complications. This is especially true for those with other health conditions (e.g., diabetes, obesity, cancer), those who’ve never received a COVID vaccine, and those living in long-term care facilities.

When should you get the COVID vaccine?
Ask your health care provider about the optimal timing of your COVID shot based on the time of year, your last vaccination, and any recent COVID infections.

How does Medicare cover the COVID vaccine?
Medicare covers the COVID vaccine through Medicare Part B. If you have original Medicare, you will pay nothing out of pocket as long as you visit a doctor or pharmacy that accepts Medicare assignment. If you have a Medicare Advantage plan, you generally must get the vaccine from a health care provider or pharmacy that is in your plan's network.

6. Hepatitis B vaccine

Who should get the Hepatitis B vaccine?
Under CDC guidance, the hepatitis B vaccine is advised for all adults ages 19–59 and for adults age 60 and older with risk factors like diabetes, chronic liver disease, or kidney disease. People age 60 and older without known risk factors may also choose to get vaccinated after talking with their health care provider.

The hepatitis B vaccine is typically given in a series of two or three injections, depending on the specific vaccine. Once you've completed the recommended series, you generally don't need a booster.

Why is the Hepatitis B vaccine important?
Hepatitis B (or hep B) is a contagious virus that infects the liver. The liver and its function change as we age, making hep B more prevalent among older adults. Your risk of contracting hepatitis B increases if you have hemophilia, end-stage renal disease (ESRD), diabetes, or other conditions that lower resistance to infection. Acute hep B is particularly dangerous for older adults because there is no specific treatment for the symptoms.

When should you get the Hepatitis B vaccine?
Most Americans are vaccinated against hepatitis B as infants. If you are not sure if you’ve been vaccinated or if you are in a situation where you may need to update your vaccination, talk to your doctor.

How does Medicare cover the Hepatitis B vaccine?
Medicare Part B insurance covers the full cost of the hep B vaccine if:

• A doctor determines you are at high or medium risk of contracting the hep B virus, and
• The physician or health care provider administering the vaccine accepts Medicare.

Talk to your doctor to determine your risk of getting hepatitis B.

Make a plan to get vaccinated today

Getting vaccinated is an important part of staying healthy and active as you age—and it also helps protect the health of your friends and family. If you have Medicare, you may pay nothing for recommended vaccines depending on the type of coverage you have. Check with your Medicare plan for specific coverage details and requirements.

Sources

1. Centers For Disease Control and Prevention. Manual for the Surveillance of Vaccine-Preventable Diseases - Chapter 11: Pneumococcal. January 17, 2025. Found on the internet at https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-11-pneumococcal.html

2. CIDRAP. COVID continues to exact heavy toll on older US adults, study suggests. January 7, 2026. Found on the internet at https://www.cidrap.umn.edu/covid-19/covid-continues-exact-heavy-toll-older-us-adults-study-suggests