In 2023, there have been some big changes to how Medicare covers vaccinations. Overall, it’s a really good thing for you but there’s been a lot of confusion around who covers what and how.. For that reason, let’s get really clear on what the rules are and what to look out for.
- Medicare & Vaccines
- Medicare Part B & Vaccines
- Medicare Part D & Vaccines
- How to ensure your vaccines are covered
Medicare & Vaccines
Unfortunately, people tend to put off vaccinations because Medicare has not always covered them.
There’s a wide range of vaccinations, and some are covered under Medicare Part B, and others are covered by Medicare Part D drug plans.
In the past, the vaccines covered by Medicare Part D have had cost associated. As a part of the 2022 Inflation Reduction Act, a rule was passed was a rule was passed, to make Medicare Part D vaccinations free.
The problem is that it wasn’t updated in all the different Medicare Part D documents or pharmacies, so there is a lot of confusion around coverage.
Medicare Part B & Vaccines
Vaccinations covered by Medicare Part B include:
- Influenza (flu)
- Pneumococcal (pneumonia)
- Hepatitis B
- COVID-19
Now there might be an administrative fee, but you can always expense that cost.
Medicare Part D & Vaccines
As I said above, these vaccines no longer have a cost associated with them. They are:
- Shingles
- Tetanus
- Diptheria
- Pertusis
How to ensure your vaccines are covered
With Medicare Part B, you can go directly to a pharmacy and present your Medicare card to get your vaccines covered. However, you can also make an appointment with your PCP directly to have these administered. This is completely up to your preference.
With Medicare Part D, you’ll first want to make sure you’re going to a preferred pharmacy within your plan’s network.
Second, when you go to the pharmacy to get your vaccines, you will want to present your Medicare card. Some pharmacies may ask you to pay a cost pay for a vaccination. And that’s not accurate, as you should be paying nothing for your Medicare Part D vaccination. So if you are going to the pharmacy and getting that vaccination, they’re asking you for money. Start asking questions. Ensure they know that you have a Part D or Medicare Advantage plan.
You have to be your own best advocate when it comes to knowing how this coverage work and knowing what your cost is because a lot of confusion in the market.
To get help with your Medicare decision, you can register for my next free online Medicare workshop by going here: https://join.themedicarecoach.com/free-workshop
