People with Medicare can get one flu shot per year free of charge. The cost does not apply to the deductible, and there is no copayment or coinsurance.
This means that the agency covers 100% of the cost. Both Medicare Part B and Medicare Advantage Plans provide the coverage.
It is important to note, however, that Medicare does not cover the cost of a flu shot from every provider. The shot must come from providers who have agreed to accept Medicare-approved payment.
Medicare pays these providers directly, and the providers view the payment as full reimbursement.
Below, we investigate the cost, coverage, and necessity of the flu shot, as well as its possible side effects. Then, we describe flu symptoms and complications.
Medicare covers the entire cost of one flu shot per year. Both Medicare Part B and Medicare Advantage plans provide this coverage.
For some people, doctors recommend additional flu shots, and Medicare may cover these as well.
For instance, if someone receives a flu shot in January, they may be eligible for another in October of the same year, and Medicare may cover the cost of the second shot.
If a person has health insurance rather than Medicare, they can get a flu shot with little or no expense.
Still, some insurance plans only cover the shot if a person receives it from their doctor. Other plans provide coverage if the shot comes from certain other locations.
Some plans cover shots from drugstores, such as Walgreens and Rite Aid, and supermarkets, such as Walmart and Kroger. Some wholesalers, such as Sam’s Club, also provide flu shots.
Before getting a shot at a retailer, it is important to check with the insurance company about coverage.
Preventive measures, such as frequent hand washing, help lower the incidence of the illness. While these strategies are beneficial, the flu shot offers the best protection.
Several strains of flu exist and they mutate every year. Also, a person’s immune response declines over time. For these reasons, it is important to get a flu shot regularly — each year.
The Centers for Disease Control and Prevention (CDC) recommend that everyone receive flu shots, beginning at 6 months of age.
However, in rare circumstances, a doctor may advise a person with a specific underlying health issue not to get the shot.
Flu shots offer wide-ranging benefits. First, they reduce the risk of developing the flu.
By preventing the flu, the shot prevents the spread of the flu virus. As a result, it prevents related doctors’ visits and absences from school and work.
Because the shot prevents the illness, it also prevents the flu from causing health complications, which can be life threatening. A 2013 review of studies, for example, found that the flu shot was linked to a lower risk of heart attacks and strokes in high-risk individuals.
Some people fear that the flu shot will give them the flu, but this cannot happen. Learn why here.
While the flu shot cannot cause the flu, it can produce side effects. These may include:
- pain, redness, or swelling at the injection site
- a low-grade fever
- an upset stomach
- muscle aches
Serious reactions occur very rarely. It is helpful to remember that getting the flu shot is much safer than contracting the flu.
Symptoms of the flu often arise suddenly. They can range from mild to severe and include:
Most people recover from the flu in under 2 weeks, and some people recover in a few days. However, others develop life threatening complications.
Below are moderate-to-severe complications of the flu:
- sinus and ear infections
- inflammation of the brain, heart, or muscles
- respiratory or kidney failure
- sepsis, an extreme inflammatory response that can be fatal
Some groups have a higher risk of developing complications, including:
Medicare covers one flu shot per year. If a doctor recommends additional shots, it may cover these as well.
Also, health insurance plans cover the flu shot, though they may place restrictions on where a person can receive the shot for free.
Before having a flu shot, it is important to check whether the shot provider accepts Medicare-approved payment.
The flu shot can cause side effects, but it cannot cause the flu. Medical experts recommend getting a flu shot every year, as the benefits outweigh the risks for the majority of people.
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