If you have been putting off the shingles vaccine because of the cost, here is news worth acting on: Medicare now covers the shingles shot for free. Since January 2023, the vaccine has been fully covered with no copay and no deductible, a major change from the system before. This guide explains how the coverage works, the one requirement to get it free, and how to avoid a billing mistake. Coverage and costs change, so verify current details before relying on them.
The Short Answer
Yes, and it is now $0. Since January 1, 2023, Medicare Part D covers the shingles vaccine, Shingrix, at no out-of-pocket cost, with no copay and no deductible. Both doses of the two-dose series are free. The one requirement is that you must have Part D drug coverage.
Which Part Covers It
This is the crucial detail. The shingles vaccine is covered under Part D, your prescription drug coverage, not Part B. That is because it is a commercially available preventive vaccine rather than one of the small set, like the flu and pneumonia shots, that Part B covers. So you must have a Part D plan, or a Medicare Advantage plan that includes drug coverage, to get the shingles shot free.
The $0 Rule and Why It Changed
Under a 2022 law, Part D now covers all recommended adult vaccines at no cost, including shingles, RSV, and Tdap. Before 2023, the shingles vaccine could carry significant cost-sharing that discouraged people from getting it. Removing that cost had a real effect: shingles vaccinations jumped sharply in the first year, and millions of enrollees received a free vaccine.
The One Big Gotcha
The most common way to end up with an unexpected charge is a billing problem. To get the shot free, the pharmacy or provider must bill your Part D plan correctly. The cleanest path is getting it at an in-network pharmacy, where they routinely bill Part D. At a doctor’s office, the office may not bill Part D directly and could charge you upfront, leaving you to seek reimbursement. Always ask how it will be billed before you get the shot. And remember, if you have only Original Medicare Parts A and B with no Part D plan, you have no Medicare coverage for the shingles vaccine and would pay out of pocket.
Who Should Get It
The shingles vaccine is recommended for adults 50 and older, and for immunocompromised adults 19 and older, so essentially all Medicare beneficiaries are eligible by recommendation. See our guide to shingles vaccine side effects for what to expect from the shot itself.
What to Do
Make sure you are enrolled in a Part D or Medicare Advantage drug plan, then get the vaccine at a pharmacy in your plan’s network and confirm it is billed to Part D rather than as a medical claim. If you are charged despite having Part D, contact your plan, since it was likely billed incorrectly, and you can request a coverage determination or reimbursement.
The Change That Made the Shot Free
There is good news about the shingles vaccine and Medicare. A recent change removed the cost.
The shingles vaccine is covered under Medicare Part D. Thanks to a recent law, recommended vaccines under Part D, including shingles, are now available at no cost to you. That means no copay or deductible for the shot. This makes protecting yourself much more affordable.
Who Should Get the Shingles Shot
The shingles vaccine is recommended for most older adults. It prevents a painful condition.
Shingles causes a painful rash and can lead to lasting nerve pain. The vaccine greatly reduces the risk. It is generally recommended for adults 50 and older, and for some younger people with weakened immune systems. Ask your doctor if it is right for you.
How to Get It at No Cost
Getting the free shot is simple. You just need Part D coverage.
You can usually get the shingles vaccine at a pharmacy that works with your Part D plan. Show your Part D card. If you are unsure, call your plan to confirm the shot is covered at no cost. Then schedule it at a participating pharmacy.
Medicare and Shingles Shots FAQs
Does Medicare cover Shingrix?
Yes, under Part D, at $0 with no copay or deductible.
Which part of Medicare covers it?
Part D, your prescription drug coverage, not Part B.
What if I only have Parts A and B?
Without a Part D plan you have no Medicare coverage for the shingles shot and would pay out of pocket.
Is it really free now?
Yes, since January 1, 2023. There is no copay and no deductible.
Where should I get it?
An in-network pharmacy is the most reliable place to get it billed correctly and free.
Are both doses covered?
Yes. The full two-dose Shingrix series is covered at $0.
