Savvy Living

My spouse and I recently turned 65 and would like to find out which vaccines are recommended and covered by Medicare?

All recommended vaccines for adults, age 65 and older, should be covered by either Medicare Part B or Part D, but there are some coverage challenges you should be aware of. Here is a list of which vaccines are recommended by the Centers for Disease Control and Prevention (CDC) and how Medicare covers them. You should consult with your healthcare professional to determine the best course of action for your particular health circumstances.

COVID-19: Even though COVID-19 is no longer a public health emergency, it can still cause severe illness, particularly in older adults. The COVID virus continues to mutate, and new vaccines are being developed to keep pace. The CDC recommends that adults 65 and older stay up to date with the latest COVID vaccines, including booster shots. All COVID-19 vaccinations are covered by Medicare Part B.

Flu: People of all ages should receive flu shots in the fall when flu season begins. The CDC recommends adults 65 and older receive a high-dose flu shot for extra protection beyond what a standard flu shot offers. The Fluzone High Dose Quadrivalent, FLUAD Quadrivalent and FluBlok Quadrivalent are the three options available. Annual flu shots are covered under Medicare Part B.

Pneumonia: Pneumonia vaccines help protect against pneumococcal disease, which can cause pneumonia, meningitis and other infections. The CDC recommends adults 65 and older get a pneumococcal vaccine. There are several different vaccine options available, so talk to your doctor or pharmacists to find out which is best for you or visit the CDC's Pneumococcal Vaccination webpage at CDC.gov/vaccines/vpd/pneumo/public/index.html. Medicare Part B covers both single dose and two-dose pneumococcal shots once in your lifetime.

Shingles: Shingles is a painful, blistering skin rash that affects more than 1 million Americans every year. It is recommended that adults over age 50 get the two-dose Shingrix vaccine. The vaccine is comprised of two doses that are given two to six months apart and are recommended even if you previously received Zostavax. In 2020, Shingrix replaced Zostavax, which is no longer available in the U.S. All Medicare Part D prescription drug plans cover shingles vaccinations, but coverage amounts, and reimbursement rules vary depending on where the shot is administered.

Tdap: Tetanus, diphtheria, and pertussis (whooping cough) are diseases caused by bacteria that can lead to serious illness. A one-time dose of the Tdap vaccine is recommended to all adults who were not vaccinated as children. If you have already had a Tdap shot, you should get a Tdap or tetanus-diphtheria (Td) booster shot every 10 years. All Medicare Part D plans cover these vaccinations.

RSV: Respiratory syncytial virus (RSV) can lead to pneumonia or bronchiolitis and can worsen other chronic conditions common among older adults, such as asthma and chronic obstructive pulmonary disease (COPD). The CDC recommends all adults, age 60 and older, talk to their doctor about getting one of the RSV vaccines (either Arexvy or Abrysvo), usually in the fall and winter months when the virus is most prevalent.

Most Medicare Part D plans cover the RSV vaccine. You can also pay for the shot out-of-pocket and then follow-up with your plan to get reimbursed. If you are not enrolled in Medicare Part D, you may have to pay for the immunization.

Other Vaccinations

There are other vaccines you may need depending on your health, lifestyle or travel plans. To help get a handle on which ones are appropriate for you, take the CDC's What Vaccines Do You Need? quiz at www2.cdc.gov/nip/adultimmsched. Also, talk to your doctor during your next visit about what vaccinations you should get.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.