Carson City January 26, 2023
As of January 1, 2023, those with a Medicare drug coverage plan no longer have an out-of-pocket expense for vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
Vaccines for both shingles (herpes zoster) and Tdap (tetanus, diphtheria, and pertussis - also known as whooping cough) covered by Medicare Part D plans no longer require payment from the patient. This change means that Part D cost sharing now aligns with Medicare Part B coverage, which already covers flu, pneumonia, hepatitis B and COVID-19 vaccinations at no cost to the individual.
Those with Medicare Part B and Part D coverage will not have to pay a deductible nor owe any copayment, coinsurance, or cost-sharing for covered vaccines.
“Any time access to vaccines can become more equitable and affordable is a time that we are going to celebrate,” said Kristy Zigenis, Section Manager for the Nevada State Immunization Program (NSIP) of the Nevada Division of Public and Behavioral Health. “We encourage those who may have been putting off getting these vital vaccinations due to cost to consult your health care provider about which vaccines are right for you. Adults never outgrow the need for immunizations, and vaccines are the best way to protect yourself and your loved ones from getting and spreading certain diseases.”
The Medicare Rights Center advises that Medicare plan holders should ensure “...that their health care provider or pharmacy administering the vaccines will bill your Part D plan. When you get a vaccine at your doctor’s office, ask the provider to call your Part D plan first to find out if your provider can bill your Part D plan directly.”
Vaccines are available through primary care providers, pharmacies, local health districts and Federally Qualified Health Centers throughout Nevada. Visit the Centers for Disease Control and Prevention (CDC) website for an Adult Immunization Schedule by Vaccine and Age Group.
For more information on Medicare, visit medicare.gov or call 1-800-MEDICARE.
Immunization records can be accessed through the Nevada WebIZ public portal at IZRecord.nv.gov.