Medicare covers a wide range of vaccines at no cost to you, split between two parts of the program. Part B covers four specific vaccines directly, while Part D (prescription drug coverage) picks up every other vaccine recommended by federal health authorities. Since January 2023, a change in federal law eliminated all copays and deductibles for recommended vaccines under Part D, meaning most Medicare beneficiaries now pay nothing out of pocket for nearly every standard adult vaccine.
Vaccines Covered Under Part B
Medicare Part B acts as your medical insurance and directly covers four categories of vaccines:
- Flu shots: One per flu season, including the higher-dose version recommended for adults 65 and older. You pay nothing if your provider accepts Medicare’s standard payment terms (called “accepting assignment”).
- COVID-19 vaccines: Part B covers the updated 2025–2026 formulas from Moderna, Pfizer-BioNTech, and Novavax at no cost. If you’re in a Medicare Advantage Plan, you’ll need to use an in-network provider to avoid charges.
- Pneumococcal (pneumonia) shots: Covered for adults 50 and older, and for younger adults with certain medical conditions. The specific vaccine type and number of doses depend on your vaccination history. If you’ve never had a pneumococcal vaccine, you’ll typically need one dose. Some people who received older versions may qualify for an updated shot at least one to five years after their last dose.
- Hepatitis B shots: Covered if you’ve never completed the full series, don’t know your vaccination history, or have a condition that raises your risk of infection (such as living with someone who has hepatitis B).
These Part B vaccines are covered regardless of whether you have a Part D drug plan. You pay nothing as long as your provider accepts assignment.
Vaccines Covered Under Part D
Part D covers every adult vaccine recommended by the Advisory Committee on Immunization Practices (ACIP), which is the federal panel that sets the U.S. immunization schedule. This is a broad category that includes:
- Shingles (Shingrix): A two-dose series recommended for adults 50 and older.
- RSV: Recommended for adults 75 and older, and for adults 50 to 74 who have conditions that put them at higher risk for serious RSV complications.
- Tdap (tetanus, diphtheria, whooping cough): Recommended as a one-time dose for all adults, with a tetanus booster every 10 years.
- Measles, mumps, rubella (MMR)
- Travel vaccines: Part D covers ACIP-recommended vaccines you might need before international travel, including yellow fever, chikungunya, and Japanese encephalitis.
The key change came from the Inflation Reduction Act, which took effect January 1, 2023. Before that law, Part D enrollees often faced copays of $50 to $200 or more for vaccines like shingles. Now your Part D plan cannot charge a copayment or apply a deductible for any ACIP-recommended vaccine. In the first year alone, 10.3 million Part D enrollees received a recommended vaccine at no charge, saving more than $400 million collectively in out-of-pocket costs.
What You Need to Pay
For Part B vaccines, you pay $0 when your provider accepts assignment. Most doctors and pharmacies that work with Medicare do accept it, but it’s worth confirming before your visit. If you’re in a Medicare Advantage Plan, make sure you go to an in-network provider for the same $0 cost.
For Part D vaccines, you also pay $0 at any pharmacy or provider that’s in your plan’s network. You don’t need to meet your annual Part D deductible first. The vaccine is simply free at the point of service.
If you have Original Medicare (Parts A and B) but no Part D plan, you’re still fully covered for the four Part B vaccines. However, you would have to pay out of pocket for vaccines that fall under Part D, like shingles, RSV, and Tdap. This is one practical reason to carry a Part D plan even if you take few prescription medications.
Pneumococcal Vaccine Timing
Pneumonia vaccination has gotten more complex in recent years because newer vaccines have replaced older ones, and Medicare’s coverage rules were updated in late 2024 to match current recommendations. Here’s the general picture:
If you’re 50 or older and have never had a pneumococcal vaccine (or don’t remember), you need one dose of a newer conjugate vaccine. Depending on which version your doctor chooses, you may also need a follow-up dose of a different type at least a year later.
If you received an older pneumonia vaccine years ago, you may still qualify for an updated shot. The waiting period is typically one to five years after your last pneumococcal dose, depending on which vaccines you’ve already had. Your doctor or pharmacist can look at your records and tell you what you’re due for. Part B covers all of this at no cost.
Where to Get Vaccinated
You can receive Medicare-covered vaccines at your doctor’s office, a pharmacy, or a community health center. For Part B vaccines (flu, COVID-19, pneumonia, hepatitis B), most settings can bill Medicare directly. For Part D vaccines (shingles, RSV, Tdap, and others), pharmacies are often the most convenient option since they can process your Part D plan on the spot.
Bring both your red, white, and blue Medicare card and your Part D or Medicare Advantage plan card. If you’re getting a Part D vaccine at a location that can’t bill your drug plan directly, you may need to pay upfront and submit a claim to your plan for reimbursement. Pharmacies in your plan’s network will almost always handle the billing for you.