Which Vaccines Are Recommended for Medicare Recipients Over the Age of 65 and Covered by Medicare, Including Challenges in Coverage?

By Divya Apr 17, 2024 #Medicare #seniors #vaccines
Which Vaccines Are Recommended for Medicare Recipients Over the Age of 65 and Covered by Medicare, Including Challenges in Coverage?

Recommended Vaccines for Medicare Recipients Over 65

Covered by Medicare

Medicare covers the cost of recommended vaccines for adults age 65 and older. These vaccines are essential for protecting seniors from serious illnesses and complications.

COVID-19

  • Recommended: Up to date on the latest COVID-19 vaccines, including booster shots
  • Coverage: 100% covered by Medicare Part B

Flu

  • Recommended: Annual high-dose flu shot
  • Coverage: Covered under Medicare Part B

Pneumonia

  • Recommended: Pneumococcal vaccine, either single-dose or two-dose
  • Coverage: Medicare Part B covers both once in a lifetime

Shingles

  • Recommended: Two-dose Shingrix vaccine
  • Coverage: All Medicare Part D prescription drug plans

Tdap

  • Recommended: One-time dose of Tdap vaccine
  • Coverage: All Medicare Part D plans

RSV

  • Recommended: Discuss with your doctor about getting an RSV vaccine
  • Coverage: Most Medicare Part D plans cover RSV vaccines, but not all

Challenges in Coverage

While Medicare covers the cost of recommended vaccines, there are a few challenges in coverage to be aware of:

  • Shingles: Coverage amounts and reimbursement rules for shingles vaccinations vary depending on where the shot is given. Check your plan.
  • RSV: Not all Medicare Part D plans cover RSV vaccines. If your plan doesn’t cover it, you can ask for a coverage exception.
  • OutOf-Pocket Costs: If you pay for the RSV shot upfront, your Medicare plan must pay you back.

Why Vaccines Are Important

Vaccines are crucial for protecting seniors from:

  • Serious illnesses: Vaccines can prevent or reduce the severity of diseases such as COVID-19, flu, and pneumonia.
  • Hospitalizations and deaths: Vaccines help keep seniors out of the hospital and reduce the risk of death from preventable diseases.
  • Long-term health problems: Vaccines can protect against long-term complications, such as lung damage from pneumonia or nerve damage from shingles.

Take Control of Your Health

Talk to your doctor about which vaccines are right for you and ensure your Medicare coverage is up to date. By staying vaccinated, you can take control of your health and live a longer, healthier life.

also read:How are vaccines funded on the National Immunization Program in Australia and New Zealand?

By Divya

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