Medicare Part D, which is the part of Medicare that deals with medications, covers the shingles vaccine. However, it does not always take care of 100% of the cost.
In this article, we explore the coverage of the shingles vaccine, as well as locations where people can get it.
We also look at the dosage, effectiveness, and possible side effects, along with the symptoms and complications associated with shingles.
Neither Medicare Part A, the hospital insurance, nor Part B, the medical insurance, cover the shingles vaccine.
However, Medicare Part D does cover it. People with Part D may be responsible for a portion of the cost, called the copayment.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Under some Medicare Part D plans, people may need to pay the entire cost at the time they get the shot. When this happens, Medicare will reimburse them later up to the plan’s allowable charge.
If the provider charges an amount that exceeds the allowable charge, the person with Medicare D is responsible for the difference.
To prevent an unexpected expense, an individual may want to check the allowable charge for vaccines from their Medicare Part D plan before getting the shot. They can compare it with the amount the provider charges.
Two shingles vaccines are available: Shingrix and Zostavax. Doctors prefer the former because it offers stronger protection.
It is possible for some people who do not have either Medicare Part D or private insurance to get the shingles vaccine.
Some drug companies provide it free of charge. People who are unable to afford the shot should ask a doctor about this possibility.
People may get the shingles vaccine at a doctor’s office. They may also get it at a drugstore if they have a doctor’s prescription.
Individuals may find a place near their home that provides the shot by visiting HealthMap Vaccine Finder.
About 1 in 3 people get shingles in the United States, and the risk increases with age.
Anyone who has had chickenpox in the past can develop shingles. Whether or not a person remembers having the disease as a child, medical experts urge them to have the shot if they are aged 50 and older.
Even if a person has had shingles, they can still get it a second time. For this reason, doctors advise them to get vaccinated.
Who should not get the shingles vaccine?
Doctors also recommend that people with allergies to any component of the vaccine do not have the shingles vaccination.
Anyone with severe allergies must tell a doctor about them when discussing their shingles risk.
The CDC recommend that adults aged 50 and older get two doses of the shingles vaccine Shingrix. Providers administer the doses 2 to 6 months apart.
The CDC add that this 2-dose regimen is more than 90% effective against shingles. The protection lasts above 85% for at least 4 years after the second dose.
Although the shingles vaccine called Zostavax is less effective, it is a good alternative if, for example, a person is allergic to Shingrix.
The shingles shot is safe, but it may cause side effects that limit normal activities for 2 to 3 days. Most people experience soreness in the arm, with mild or moderate pain.
Other side effects: include
There is a very small risk that some people may experience a severe allergic reaction to the shot. Symptoms of this include difficulty breathing, hives, weakness, a fast heartbeat, and swelling of the face.
Anyone who thinks they are having a severe allergic reaction should get immediate medical help.
Shingles is an outbreak of a painful rash of blisters. It comes from the same virus that causes chickenpox.
According to the National Institute of Neurological Disorders and Stroke (NINDS), the rash most commonly presents as a band on one side of the abdomen. Symptoms usually last 3–5 weeks.
The symptoms range from mild to intense. They include:
- burning or shooting pain
- a fever
- an upset stomach
Sometimes shingles can cause complications. The most common one is severe pain in the area of the rash. This pain may decrease within a few weeks or months, but some people may experience it years later. This complication is called postherpetic neuralgia.
Some people develop shingles on the face. If it affects the eyes, it can occasionally result in temporary or permanent vision loss.
When the rash appears within or near the ear, there is the possibility it can cause hearing or balance problems.
Medicare Part D covers the shingles vaccine, but people with these plans may be responsible for a copay. The copay amount can vary depending on the plan and the provider.
Many private health insurers also cover part of the shot’s cost. People with a low income who do not have Medicare or private insurance may get the shingles vaccine at no cost from certain drug companies.
Side effects of the shingles vaccine are usually mild. Doctors advise healthy older adults to get the Shingrix vaccine because it is very effective.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.