If you qualify, Original Medicare covers vaccinations at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). 

Medicare Advantage Plans are required to cover vaccinations without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.

Always ask if a provider participates with Medicare or your Medicare Advantage Plan before you get any services. 

Medicare Part D covers most vaccines and immunizations, including the Shingles vaccine, but there are certain vaccinations that are covered by Part B:

  • Influenza (flu) shots, including both the seasonal flu vaccine and the H1N1 (swine flu) vaccine 
  • Pneumococcal (pneumonia) shots 
  • Hepatitis B shots 
  • COVID-19 vaccine and booster(s) for certain persons

Part B also covers vaccines after you have been exposed to a dangerous virus or disease such as a tetanus shot if you step on a rusty nail.

The Food and Drug Administration (FDA) has approved an additional dose of the COVID-19 vaccine or booster for certain at-risk populations and people 65 or older. The additional dose is covered by Medicare with zero cost-sharing. 

Beware! Scammers may try to bill Medicare for sham tests or treatments related to COVID-19 and they target individuals to illegally obtain money or Medicare numbers. Also, don’t post photos of your COVID-19 vaccination card on social media, to prevent identity theft. Remember: creating or using fake vaccination cards is illegal. 

If you have questions about services covered by Medicare, call MMAP at 1-800-803-7174.

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