People with Medicare can get one flu shot per year free of charge. The cost does not apply to their deductible, and they will not have any copayment or coinsurance.
Medicare pays healthcare professionals directly when they administer flu shots, and the healthcare practice views the payment as full reimbursement.
This article includes more information on which parts of Medicare cover the flu shot and how a person can ensure it comes at no additional cost to them.
Medicare covers the entire cost of one flu shot per year, per the Centers for Medicare & Medicaid Services.
Both Medicare Part B (medical insurance) and Medicare Advantage (Part C) plans provide this coverage.
A person should note, however, that Medicare does not cover the cost of a flu shot from every healthcare practice. The shot needs to come from healthcare professionals who agree to accept Medicare.
Medicare may cover two shots over a single calendar year. For instance, if a person 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, according to Medicare Interactive.
For some people, doctors recommend additional flu shots. Medicare may cover the cost of these shots if they a healthcare professional deems them “medically necessary.”
A person should ask their doctor for more information about recommended additional doses.
If a person has Medicare Part B, a Medicare Advantage plan, or private health insurance, they can get a flu shot for free.
The Affordable Care Act (ACA) requires that insurance companies cover the cost of the flu shot. Plus, under the ACA, insurers cannot charge a copayment, per the Department of Health & Human Services.
A person should check with the site providing the shot to make sure they accept assignment from Medicare or accept Medicare Advantage. People with private insurance should check their plan to make sure they can get the shot from a particular location for free.
Some insurance plans cover the shot only if a person receives it from their doctor. Other plans provide coverage if the shot comes from certain other locations as well.
Medicare covers one flu shot per year. Before having a flu shot, though, a person should also check whether the shot provider accepts a Medicare-approved payment.
If a doctor recommends additional shots, it may cover these as well. However, a person should double-check this before getting a second shot.
People with Medicare Advantage or private health insurance plans may have the option of getting the flu shot for free. A person should check with their plan and healthcare professional to make sure their plan will cover the cost.