Medicare Parts B and D provide cover for certain tetanus shots, depending on the type of plan a person has. There are options to help reduce out-of-pocket costs or get the vaccine for free.

Medicare is a federal insurance plan for people over 65 and for younger people with specific health conditions.

Medicare Part A covers inpatient care, and Part B provides cover for outpatient services.

Part B usually provides cover for vaccinations, but sometimes a person is required to have Medicare Part D for specific shots.

Medicare Part D covers prescription drugs, and private insurance companies administer these plans.

In this article, we discuss whether Medicare covers tetanus shots, the out-of-pocket expenses, and the cost of the shots.

Glossary of Medicare terms

We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
  • Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
  • Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
  • Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
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Some people know the disease as lockjaw because tight jaw muscles are a common sign of tetanus infection.

According to the Centers for Disease Control and Prevention (CDC), the disease can lead to trouble swallowing and breathing, and serious complications include broken bones, blood clots, and pneumonia.

Tetanus is uncommon in the United States.

People cannot catch tetanus directly from another person. A person can contract tetanus when Clostridium tetani bacteria in the dirt, dust, or soil enter the body through cuts, grazes, or puncture wounds.

A tetanus vaccine helps prevent infection.

Medicare Parts A, B, or D cover some vaccines needed to help prevent disease.

A vaccine is a shot people get to help protect against disease. Like any medication, they may cause some side effects. Some are mild, and most go away within a few days.

While limited cover is available under parts A and B, Medicare Part D covers most commercially available shots intended to prevent illness, including tetanus.

Four different vaccines protect against tetanus. Each vaccine also protects against other diseases:

  • diphtheria and tetanus (DT)
  • tetanus and diphtheria (Td)
  • tetanus, diphtheria, and pertussis (Tdap)
  • diphtheria, tetanus, and pertussis (DTaP)

The capital letter in the abbreviation means the vaccine has a full-strength dose. The lower case letter means the vaccine uses a smaller dose.

The DT vaccine has full-strength diphtheria and tetanus vaccines, and most babies and children receive this dosage.

The Td vaccine has full-strength tetanus and lower-strength diphtheria. It is a booster, and doctors typically give it to children over 7 years old.

The Tdap contains full-strength tetanus and lower-strength diphtheria and pertussis. Doctors may choose this vaccine for people 7 years and older. They may also give Tdap as a booster shot, but Medicare does not cover this.

Medicare Part B covers some vaccines, and others require a person to have Part D, which covers prescription drugs.

Part B

Medicare Part B covers the following vaccinations:

  • Pneumococcal: This protects against pneumococcal bacteria that cause pneumonia. Medicare Part B covers the first shot and will pay for a second if a doctor administers it at least 1 year later.
  • Hepatitis B: This shot protects against a liver infection spread by blood and other body fluids. Medicare Part B pays if a person is at medium or high risk for getting Hepatitis B.
  • Flu shot: This helps protect against seasonal flu. Medicare Part B pays for one shot every flu season.

Part D

Medicare Part D covers the following vaccinations:

  • Tdap: This vaccine protects against tetanus, diphtheria, and pertussis or whooping cough. Medicare Parts A and B do not cover the shot, but Medicare Part D will pay for the Tdap. For other shots related to tetanus, a person may wish to check their coverage with their plan provider.
  • Shingles: This is a painful rash that may last up to 4 weeks. The pain can last for years. Medicare Parts A or B do not cover the shot, but some Medicare Part D plans do.

A person’s out-of-pocket costs will include their Medicare Part D premium, deductible, coinsurance, and copayment.

Medicare has set rules that companies must follow, but the private insurance company administering the plan determines most out-of-pocket costs.

Medicare resources

For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.

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Local federally funded health centers provide preventive services, including vaccines.

They may offer a sliding fee based on income. The Health and Human Services Department provides a list of health departments in each state.

The CDC publish a vaccine price list for general information. They list the price of Tdap at around $47 for one shot depending on the brand.

Medicare Part B pays for several vaccines to help prevent disease. This includes the tetanus vaccination, but it does not pay for a Tdap tetanus booster.

Medicare Part D, the prescription drug plan, does cover the Tdap vaccine, and it also pays for most commercially available vaccines to prevent illness.

Local federally funded health centers may offer vaccines on a sliding scale. The amount a person pays depends on their income.