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Medicare Answers for Vaccines and Immunizations By Crystal Manning
A question which I frequently field from my clients is “Are recommended vaccinations and immunizations covered under my Medicare plan?” In this article I hope to address what you need to know regarding a few of the most common shots.
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f you remember how painful getting chickenpox was as a child, then you have just an inkling of how shingles feel. Therefore, many people want to know if Medicare covers the shingles vaccine. The answer is Yes, Medicare does cover the shingles vaccine, but not under Original Medicare Parts A and B. Instead, your Medicare Part D
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(prescription) plan is required to provide coverage for the shingles vaccines. If your provider recommends that you get a vaccine, in most cases it will be covered by your Part D plan. Part D plans must include most commercially available vaccines on their formularies. The only exceptions are flu, pneumonia, and hepatitis B vaccinations, which are covered by Part B, (medical). The amount you pay for your vaccine may vary depending on where you get vaccinated. Payment for Part D-covered vaccines and their administration are made solely by the participating prescription drug plan. This includes all preventive vaccines not covered under Medicare Part B. Be sure to check your plan’s coverage rules and see where you can get your vaccine at the lowest cost. Typically, you will pay the
Crystal A. Manning
Medicare Advisor
Call 412-716-4942 or email crystalmanning33@gmail.com 10008 Pine Ridge Drive Wexford, Pa. 15090
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Spring 2022 | www.PittsburghFiftyFivePlus.com
least for your vaccinations at innetwork pharmacies or through your doctor’s office, which either coordinates with a pharmacy to bill your Part D plan or bills your plan directly for the entire cost of the vaccination process (the drug and its injection). If you have qualified for economic assistance, you may go to any provider or in-network pharmacy to get vaccines. It is important to understand your Medicare coverage choices and to pick your coverage carefully. How you choose to get your benefits and who you get them from can affect your out-of-pocket costs and where you can get your care. Contact Crystal Manning, Licensed Medicare Advisor for more than 30 years, at 412-716-4942 or crystalmanning33@gmail.com. n