Overview of Shingles and the Shingles Vaccine
Shingles is a painful skin rash caused by the varicella zoster virus (VZV), which is the same virus that causes chickenpox. The virus can remain dormant in the body for years, even after the person has recovered from chickenpox, and can be reactivated later in life to cause shingles. There is currently no cure for shingles, but there are treatments available to help manage the symptoms and reduce the risk of complications.
The best way to protect against shingles is to get vaccinated. The shingles vaccine is a safe and effective way to reduce the risk of developing shingles and its associated complications. There are two types of shingles vaccines currently available in the United States: Zostavax and Shingrix. Zostavax is an older vaccine that has been approved by the FDA since 2006, while Shingrix is a newer vaccine that was approved in 2017. Both vaccines require two doses spaced two to six months apart, and are recommended for adults 50 years of age and older.
What Medicare Covers for Shingles Prevention
Medicare offers coverage for the shingles vaccine through both Part B and Part D. Medicare Part B covers the cost of the vaccine, as well as any doctor’s visits associated with getting the shot. However, it does not cover the cost of the actual shot itself. This means that you must pay out-of-pocket for the shot.
Medicare Part D is a prescription drug plan that covers the cost of certain drugs and vaccines. Depending on your specific plan, it may cover the cost of the shingles vaccine. Additionally, some Medicare Advantage plans may also offer coverage for the shingles vaccine.
How to Access the Shingles Vaccine Through Medicare
If you have Medicare Part B or Part D, then you may be able to access the shingles vaccine at no additional cost. To do so, you will need to find a provider who accepts Medicare and offers the shingles vaccine. You can search for providers in your area using the Medicare Provider Directory.
Once you have found a provider, you will need to schedule an appointment to get the shot. Your provider will be able to provide information about when and how to get the vaccine. Depending on your provider, you may be able to get the shot at the same time as your regular doctor’s visit or you may need to schedule a separate appointment.
Cost Considerations for the Shingles Vaccine Through Medicare
Before getting the shingles vaccine through Medicare, it is important to understand the costs involved. If you have Medicare Part B, then you will need to pay the Part B deductible and any applicable copays. The Part B deductible for 2020 is $198, and the copayment is 20% of the total cost of the vaccine.
If you have Medicare Part D, then you will need to pay any applicable copays. The amount of the copay will depend on your specific plan. Additionally, some Medicare Advantage plans may offer coverage for the shingles vaccine, in which case you will need to check with your plan to determine the cost.
Alternatives to Medicare Coverage for the Shingles Vaccine
If you do not have Medicare coverage or if you are unable to access the shingles vaccine through Medicare, then there are other options available. One option is to use private health insurance. Most private health insurance plans offer coverage for the shingles vaccine, although the amount of coverage varies from plan to plan.
Another option is to use discount programs. Many pharmacies offer discounts on the shingles vaccine, so you may be able to get the shot at a lower cost. Additionally, there are several vaccine-specific assistance programs that can help cover the cost of the shingles vaccine. These programs are available to those who meet certain income requirements. Finally, you can always pay out-of-pocket for the shingles vaccine. The cost of the vaccine varies depending on the type of vaccine and where you purchase it.
Conclusion
The shingles vaccine is an important tool for preventing shingles and its associated complications. Medicare offers coverage for the shingles vaccine through both Part B and Part D, although the cost of the shot itself must be paid out-of-pocket. Additionally, there are other options available for those without Medicare coverage, such as private health insurance, discount programs, and out-of-pocket payment.
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