Some Medicare Advantage plans may include coverage for the shingles shot, but it’s not covered under Original Medicare (Parts A and B).
Here’s some helpful information on the symptoms and causes of shingles, Medicare coverage of the vaccine and where to get a shot.
What is shingles?
Shingles is a viral infection caused by the same virus as chicken pox—the varicella-zoster virus. It starts as a painful rash on one side of the face or body and develops into blisters. The blisters continue to form over 3–5 days and eventually dry and crust over. Healing can take between 2–4 weeks, but shingles can leave scars and permanent pigmentation changes.1
Is the shingles shot covered by Medicare?
Original Medicare (Parts A and B) does not pay for the shingles vaccine. However, if you’re enrolled in a Medicare prescription drug plan (Part D) or have a Medicare Advantage plan (Part C) that includes drug coverage, your shot may be covered. For vaccines covered under Part D (such as Shingrix or Zostavax), it is not recommended to get the shot through your provider’s office, as you may have issues with Part D billing.*
What shingles vaccines are available?
According to the Centers for Disease Control and Prevention (CDC), there are 2 vaccines licensed and recommended to prevent shingles in the U.S.: Shingrix and Zostavax.2 The CDC recommends that healthy adults 50 years and older get 2 doses of Shingrix, separated by 2 to 6 months, to prevent shingles and the complications from the disease.
Where do you get a shingles shot?
You can generally get a shingles shot at most pharmacies. To get the shot at a pharmacy, you may need a doctor’s prescription.*
To find Humana in-network doctor’s offices or pharmacies near you that offer the vaccine, use Humana’s Find a doctor tool.
How much does the shingles shot cost?
The cost of the shot can depend on your Medicare plan, the vaccine type and where you get it. Most require a copayment, which can vary widely from plan to plan. If you haven’t met your plan’s deductible for the year, you may have to pay full price.
The CDC recommends that all healthy adults 50 years and older get vaccinated against shingles. If you have any additional questions, contact your healthcare provider for more information.
*Depending on your plan, the location where you receive the vaccine may impact coverage. Check your Explanation of Benefits (EOB) to learn if the vaccine is covered at your healthcare provider’s office, local pharmacy or both.