If you're a Medicare participant and you haven't gotten this year's flu shot or submitted your arm to the one-time shingle and pneumonia shots, you're not only risking your health. You're leaving money on the table.
While these preventive measures are covered at no additional charge to you under either Part B or Part D, only 63 percent of Medicare participants get their shots even though it doesn't cost them any extra money, says Albert Terrillion, senior director for clinical and community partnerships at the National Council on Aging. If you are too young for Medicare, but you are insured under the Affordable Care Act, these vaccinations also will be covered regardless of your deductible, Terrillion says.
Terrillion puts getting a flu shot at the top of the list. "Get your flu shot first. It is important to have the protection a flu shot provides."
The shingles shot would be second on his list for those 60 and older.
If you travel frequently, are an outdoors person or a grandparent who is around young children often, you might want to get the Tdap booster, which provides protection against whooping cough, tetanus and diphtheria. You probably had these vaccines years ago, but the benefit only lasts about 20 years, the Centers for Disease Control and Prevention, or CDC, said in a statement. It urged grandparents, in particular, to get the shot at least two weeks before visiting infants younger than 6 months, who are particularly susceptible to whooping cough and too young to be vaccinated. You can expect this shot to also be covered by either Medicare Part D or your ACA-compliant health insurance plan.
You can get these shots at your doctor's office. Terrillion recommends that you call and ask for a "preventive" visit and make clear that you're not asking for a "diagnostic" visit. That way the office staff will code your visit properly and your insurance or Medicare won't charge a co-pay nor consider whether you've met your annual deductible.
You can also get these vaccines at your local pharmacy. Terrillion says you can't get them all at once. Either your doctor or the pharmacist you use regularly will be able to schedule them properly.
"Get vaccinated," he urges. "You are making yourself, your family and your community healthier by doing the right thing."
Vaccines that Medicare pays for
|Vaccine type||Medicare coverage||Coverage rules and frequency|
|Vaccine type: Influenza||Medicare coverage: Part B||Coverage rules and frequency: Medicare pays for (and recommends) one shot every flu season. Additional flu vaccines may be covered if considered medically necessary.|
|Vaccine type: Shingles||Medicare coverage: All Part D plans must cover||Coverage rules and frequency: One shot paid for (and recommended) after age 60. Patient must check with plan to find out specific rules for administration and payment.|
|Vaccine type: Pneumococcal (pneumonia)||Medicare coverage: Part B||Coverage rules and frequency: Medicare pays for one shot, recommended for all adults aged 65+ and younger adults with chronic health conditions.|
|Vaccine type: Hepatitis B||Medicare coverage: Part B||Coverage rules and frequency: Series of three shots, paid for by Medicare for high- or medium-risk individuals, including those with hemophilia, end stage renal disease, diabetes and other chronic conditions that lower resistance to infection.|
Sources: National Council on Aging, Centers for Disease Control and Prevention