Medicare & Shingles Shot or Shingrix

Being covered by Medicare has many advantages because it helps you reduce the costs of many supplies and, thus, save money.

However, does it cover the shingles shot? Read to find out.

What Is Shingles?

Shingles is an infection caused by the varicella-zoster virus. It affects the skin, causing a rash, and sometimes it leads to nerve pain. People who had chickenpox have a higher chance of developing shingles.

While the virus may reappear anytime in people of many ages, people over 50 are the most likely to be affected by it.

Shingles starts off as a pain and itching on a specific spot of the skin. After a few days, the rash becomes visible and it looks similar to chickenpox. An episode of shingles usually lasts about 2-4 weeks.

Even if shingles is not contagious, the virus can spread to someone who has not had chickenpox. The person doesn’t contact shingles, but chickenpox. The virus can spread by making contact with the fluid from the blisters. Also, it’s good to know that chickenpox has a higher contagiousness than shingles.

Does Medicare Cover the Shingles Shot?

Sadly, the answer to this question is no, unless you have a prescription plan.

The shingles shot is not be covered by Medicare Part A or Part B. Unlike other vaccines, it can only be covered by Medicare prescription drug plans (Part D). Thus, you have to enroll in a Medicare Advantage plan or a stand-alone Part D drug plan to cover the costs.

Unfortunately, poor coverage is provided for some recommended vaccines, and it results in people having to pay a lot of money. The shingles vaccine is called Zostavax and it classifies as an expensive drug. It reduces the risk of developing shingles and if you do develop it, it reduces the nerve pain.

Commercially available vaccinations are usually covered by Medicare Advantage and Medicare prescription drug plans. However, if you are vaccinated in a pharmacy, you have to check if the respective pharmacy is included in your plan. If not, you might have to pay more.

In addition, if you are vaccinated by a doctor, you should find out if he/she can take the money directly from the plan. If not, you might be required to pay the bill upfront.

So, you should contact your Medicare Advantage Prescription Drug plan or Medicare prescription drug plan. This way, you can find out about the pharmacies included in your plan’s network. As a result, you will be able to pay less and save some money.

Will Medicare Pay for Shingrix?

You are going to want to make sure you have the correct Medicare plan (which might even reduce your costs overall).

BGA Insurance Group can help ensure that you are not surprised by charges you were not expecting. If you believe you need to get certain vaccines or prescription medications, you should contact us immediately to help you select a plan that makes the most sense for you.