The concern over getting shingles tends to grow as we age. The Centers for Disease Control and Prevention (CDC) advises people 60 years old and over to be vaccinated against shingles whether or not they remember ever having suffered from chickenpox, which is caused by the identical virus as shingles. No age limit has been set by CDC for getting the vaccine.
Medicare benefits for the shingles vaccine
The vaccine to protect against shingles is not covered by Medicare Parts A or B. However, it may be covered by your Part D prescription drug coverage. Part B does cover flu, hepatitis B and pneumococcal shots. Part D covers all the other recommended adult immunizations, which includes vaccines developed for shingles and TDAP (tetanus, diphtheria and pertussis).
How to get the shingles shot
A prescription is required and some pharmacies can deliver the shot as well. It can also be performed at a medical office. Some doctors will obtain and dispense the product, and others may require that you purchase it at the pharmacy and bring it to the doctor’s office to provide the service. Either way, be sure the pharmacy and doctor are in your plan’s network to reduce your out-of-pocket costs.
People who should not get the shot
Medicare benefits aside, the CDC suggests that people in the following situations avoid the shot:
- People with a compromised immune system, which may be due to HIV/AIDS, steroids, certain types of cancer or cancer treatments.
- Pregnant women or women planning to conceive within the month following the shot.
- Unwell people with a moderate or severe acute condition and anyone with a temperature reading of 101.3 degrees Fahrenheit or more.
Types of vaccines to help prevent shingles
There are two types of shingles vaccines on the market: Zostavax and, since 2017, Shingrix.
For healthy people who are 50 years and older, CDC recommends two doses of Shingrix two to six months apart. This vaccine protects against not only shingles but also postherpetic neuralgia (PHN), which is a common and potentially long-lasting complication of shingles that causes severe pain.
Zostavax is administered in one dose, either in a physician’s office or at a pharmacy. CDC states that it is most effective for adults between the ages of 60 and 70, and may benefit seniors 70 years and older.
Part D Medicare benefits
Through your drug plan’s administrator or website, check your coverage for the vaccine and its administration. There may be coinsurance or copayments required, so it’s a good idea to be prepared for any out-of-pocket costs. Discuss options with your doctor to determine which vaccine is appropriate for you and where the shot should be administered.
Related articles:
What Vaccines are Covered by Medicare?(Opens in a new browser tab)
Does Medicare Cover Quadrivalent Flu Vaccine?(Opens in a new browser tab)