What You Need to Know Before Getting Your Shingles Vaccine

As your advisors in Medicare, we want to give you important information you should know about shingles. According to the Centers for Disease Control and Prevention (CDC), shingles affects around one million Americans annually, and adults 60 years and older account for approximately 1 case per 100 each year.

What Is Shingles?

Shingles is a viral infection stemming from the virus that causes chickenpox. It often appears in the form of a deeply painful rash. Individuals who have had chickenpox in the past are susceptible to shingles at any point in their life, and adults over the age of 50 have an increased risk of developing it. By getting a shingles vaccine, you can greatly reduce your risk of developing the virus.

Is Shingles Covered by Medicare?

Each year, we receive questions from clients about whether shingles vaccines are covered by their Medicare plan. Some have been advised by a doctor to get vaccinated to decrease the risk of developing the infection, but many don’t realize that if they’re vaccinated at the doctor’s office, they’ll be billed for the injection and possibly an administrative fee, which can be quite costly. Neither the injection nor the administrative fee is covered under Parts A or B of Medicare.

There’s good news, though! Shingles vaccines are often covered by Medicare Advantage and Prescription Drug plans. They’re usually included on the plan’s formulary and can be billed to Medicare by a pharmacy. In many cases, the most cost-effective option for getting a shingles vaccine is to go directly to a pharmacy because you’ll avoid the administration fee and you’ll only have a copay.  Most major pharmacies don’t require a prescription to get a shingles vaccine, and the pharmacist can administer it on-site. Generally, appointments aren’t required, but we recommend calling your pharmacy ahead of time to confirm.

Keep in mind that some shingles vaccines consist of one injection, while others are a two-part series. For those with two injections, there is a separate copay required for each injection.

If you’re considering getting a shingles vaccine, we recommend you call us to discuss what is covered by your Medicare plan.

Your Advisors in Medicare

Your well-being is our top priority. Please contact our client advisors to discuss advice or questions about shingles as it relates to your personal health history.

If you’re not a RetireMEDiQ client and have questions about retirement or Medicare, contact our team of advisors in Medicare at 1-866-600-5638 or [email protected].

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