Shingles vaccines such as Zostavax and Shingrix may help protect against shingles, however, Original Medicare and Medicare Advantage plans do not typically cover the cost of such vaccines.
Medicare Part D, which is an optional prescription drug coverage provided by a private health insurer, may offer coverage for the shingles vaccine.
How does Medicare cover the shingles vaccine?
Original Medicare (Parts A and B) does not provide coverage for the shingles vaccination; however, Medicare Part D does.
To receive coverage for this vaccine, you must enroll in either a stand-alone Medicare prescription drug plan (PDP) or a Medicare Advantage plan with prescription drug benefits (referred to as a Medicare Advantage prescription drug plan).
The shingles vaccine may require a copayment.
Medicare is a federal program that provides health insurance to millions of Americans aged 65 and over, as well as people with certain disabilities. One of the many medical services covered by Medicare is the shingles vaccine, which helps protect against a painful and contagious virus. The Centers for Disease Control and Prevention (CDC) recommends that those aged 50 and up should get the shingles vaccine to help reduce their risk of getting shingles.
The shingles vaccine, known as Zostavax, is an inactivated form of the virus that causes shingles. It’s available in both single-dose vials and prefilled syringes.
When administered properly, it can help prevent shingles or reduce their severity if you do get it. According to the CDC, people who receive two doses of the vaccine are about 50 percent less likely to develop shingles than those who don’t get vaccinated.
Medicare Part D covers most of the cost of the Zostavax shingles vaccine if your doctor administers it in his or her office. Generally speaking, Medicare will cover 80 percent of the cost while you’ll need to pay 20 percent out-of-pocket — unless you have additional supplemental insurance coverage that pays for this expense.
You may be able to find lower prices for the vaccine at pharmacies participating in Medicare’s discount drug program.
Medicare Part D
Medicare Part D is a government-funded program that provides coverage for prescription medications and other related health services. One of the many benefits of this program is that it covers the cost of the shingles vaccine.
The shingles vaccine, also known as Zostavax, helps protect those at risk of developing shingles, an infection caused by the varicella-zoster virus. The vaccine is most effective when given to people over 60 years old; however, adults of all ages may be eligible for coverage.
Medicare Part D covers up to two doses of the shingles vaccine for eligible individuals. It is important to note that Medicare Part D does not pay for the entire cost of the vaccine and there may be additional costs associated with getting vaccinated such as doctor’s visit fees or copayments.
In addition to coverage from Medicare Part D, there are other ways to get help paying for the shingles vaccine. Depending on where you live, your state or local health department might provide free or low-cost vaccines for those who qualify based on their income level.
Additionally, some employers and health insurance plans offer coverage for vaccinations as part of their employee benefits packages.
Getting vaccinated against shingles can help prevent painful outbreaks and reduce long-term complications such as postherpetic neuralgia (PHN). Shingles can affect people in different ways; people with weakened immune systems due to age or certain medical conditions are more likely to experience more severe forms of it.
That’s why it is especially important they are covered under a plan like Medicare Part D so they can protect themselves from this potentially dangerous infection.
Since its introduction in 2006, Medicare Part D has provided millions of Americans with access to affordable prescription medications and vaccines including the shingles vaccine.
Knowing how this program works and what kind of coverage it offers can help you make informed decisions about your healthcare needs and ensure you receive quality care at an affordable price.
Medicare Advantage Plans
It’s important to remember that Medicare Part B doesn’t typically cover routine vaccinations like this one; however, some Medicare Advantage plans may provide additional coverage through separate contracts with providers or insurers.
If you’re unsure whether or not your plan covers this particular immunization, contact your provider for more information before making any decisions about whether or not you should get vaccinated against shingles.
Shingles is a painful condition caused by the reactivation of the same virus responsible for chickenpox — varicella-zoster virus (VZV). It typically appears as a rash on one side of your face or body along with flu-like symptoms such as fever and headache; serious complications can occur when left untreated.
Fortunately, Medicare Part D covers most of the cost for Zostavax if administered in a doctor’s office — so if you’re eligible for this coverage under Medicare then it may be wise to take advantage of it and get vaccinated against shingles now rather than later!
What is shingles?
Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. It is caused by the varicella-zoster virus, which is the same virus that causes chickenpox.
After someone has chickenpox, the virus can remain dormant in their body. Shingles, also known as herpes zoster, is a viral infection of the skin that causes an itchy and painful rash.
It is caused by the varicella-zoster virus (VZV), which is the same virus that causes chickenpox. After someone has had chickenpox, the VZV can remain dormant in their body for years and later reactivate, resulting in shingles.
The onset of shingles usually begins with pain, burning, or tingling sensations on one side of the body or face. This is followed by an outbreak of a red rash that develops into small blisters filled with fluid. The rash typically occurs along a nerve pathway and can be very painful.
Other symptoms may include fever, headaches, joint pain, chills, and sensitivity to light. Shingles do not spread from person to person but instead require direct contact with an area of broken skin or mucous membranes.
People who have had chickenpox are at an increased risk for developing shingles; however, anyone over age 50 should get vaccinated against shingles as well. While there is no cure for shingles, medications such as antiviral drugs can reduce the severity of symptoms and help speed up healing time.
In addition to medications, over-the-counter creams, and ointments may be used to relieve discomfort associated with shingles rashes.
Warm baths and soothing lotions applied directly to affected areas may also provide some relief from itching and pain associated with shingles rashes.
Additionally, good hygiene practices such as washing hands often can help prevent complications from bacterial infections that can occur due to broken skin caused by blisters associated with a shingles outbreak.
In rare cases, long-term nerve damage known as postherpetic neuralgia (PHN) can develop after a bout of shingles has healed if left untreated..
Symptoms of PHN may include chronic pain around the area where the original rash occurred that lasts longer than 3 months after healing from shingles has occurred.
Risk Factors of Shingles
Risk factors for PHN include older age and severe cases of shingles accompanied by blisters engulfing more than half of one side of the body or face.
As such, it’s important for patients suffering from shingles not only to get treatment early on to reduce symptom severity but also monitor any lingering pain past 3 months post–healing in order to detect any potential signs of nerve damage associated with PHN early on before it becomes debilitating or even life-threatening in extreme cases.
It’s important to note that while anyone who’s had chickenpox is at risk for developing shingles later in life, there are steps you can take to lower your chances.
Getting the recommended vaccine at age 50 or older, maintaining healthy habits including getting adequate exercise, eating healthy, avoiding stress, getting plenty sleep, drinking lots of water and other fluids, managing existing health conditions like diabetes, high blood pressure, and high cholesterol are all excellent ways reduce your risk for future outbreaks.
What shingles vaccines are available?
In the United States, two vaccines are available for preventing shingles: Zostavax and Shingrix.
Zostavax is a live attenuated vaccine designed to prevent herpes zoster (shingles) in those aged 60 and over. An individual receives one dose of Zostavax at any time after turning 60 years old. This vaccination is available through pharmacies across the US and is typically covered by private insurance plans or Medicare Part D drug plans.
The second vaccine available in the US is Shingrix, which was approved in 2017. Shingrix is administered in two doses given 2–6 months apart and is recommended for individuals between 50 and 59 years of age. It has been found to be 97% effective in preventing shingles in people aged 50-59 and 91% effective in people aged 60-69—significantly higher than Zostavax’s efficacy rate of 51%. Much like Zostavax, Shingrix is distributed through pharmacies nationwide and is typically covered by private insurance plans or Medicare Part D drug plans.
Who Should get the Shingrix Vaccine?
Shingles is a painful and potentially dangerous virus that can cause serious complications in individuals of any age, which is why it’s important to make sure those who may be at risk are vaccinated.
The shingles vaccine is recommended for adults over the age of 50, but there are other groups who should also consider getting the vaccine in order to protect themselves against the virus.
The first group of people who should get the shingles vaccine is those with weakened immune systems. People with HIV, cancer or those undergoing chemotherapy treatments have a greater chance of becoming infected with shingles than those with healthy immune systems. These individuals should talk to their doctor about getting vaccinated in order to help reduce the risk of infection.
In addition to individuals with weakened immune systems, anyone who has already had shingles before should also consider getting vaccinated against it. Even though having shingles once does not guarantee an individual will get it again, their chances of developing a recurrent case increase significantly if they do not get vaccinated.
This is because when someone has been infected with the virus once, their body already contains some of the antibodies needed to fight off future infections – something that can only be done by vaccination.
Lastly, anyone aged 50 or above should look into getting vaccinated against shingles as soon as possible. Although most cases occur in individuals aged 60 and older, younger people may still become infected with shingles if they have not received a vaccination yet.
Plus, thanks to recent advances in medicine and science, there are now vaccines specifically designed for adults over 50 that provide more protection against shingles than ever before.
Ultimately, anyone who fits into any of these categories – individuals with weakened immune systems, those who have had shingles before, and those over 50 – should speak with their doctor about whether or not they need to get vaccinated against shingles sooner rather than later.
Vaccination helps reduce one’s risk of developing this virus and its complications and could even save lives in some cases.
By getting protected from this highly contagious virus now, you can rest assured knowing that you’re doing everything you can to keep yourself safe from potential harm down the line
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.