What vaccines are covered by Medicare?

Medicare Part B (which primarily covers medical outpatient care costs) covers four recommended vaccines for all Medicare beneficiaries: COVID-19, hepatitis B (whether or not a risk factor is reported), influenza, and recommended pneumococcal conjugate and pneumococcal polysaccharide vaccines. Medicare Part B does not cover other adult vaccinations (e.g., Tdap) unless they are directly related to the treatment of an injury or direct exposure to a disease, such as anti-rabies treatment or tetanus prevention due to an injury. In the absence of injury or direct exposure, all other vaccines, including zoster, are covered by Medicare Part D.

Medicare Part D plans (outpatient prescription drug insurance) cover the Advisory Committee on Immunization Practices (ACIP) recommended vaccines that Part B does not cover (for example, RSV and zoster). Since early 2023, the Inflation Reduction Act of 2022 has required Medicare Part D plans to cover ACIP-recommended adult vaccinations without a deductible or copay when given by an in-network provider. Medicare Part D coverage also includes ACIP-recommended vaccines recommended for an individual as a result of occupational or travel-related risks. A summary of adult vaccine insurance coverage can be found at www.izsummitpartners.org/content/uploads/NAIIS_Vaccine-insurance-coverage-2024-2025.pdf.