Toni’s Tips: Getting a Free Shingles Shot with Medicare

Hello Toni,

I became a Medicare member last October, yet I didn’t enroll in a Medicare prescription drug plan. I visited my doctor for my annual physical last April, and they charged me $200 for a shingles vaccination. They informed me that if I was enrolled in a Medicare Part D prescription drug plan, I wouldn’t have had to pay anything for the shingles shot. I was under the impression that vaccinations and immunizations were covered by Medicare at no extra cost.

I attempted to sign up for a Part D plan on the Medicare website after my doctor’s visit in April, but I was informed that according to Medicare’s Part D rule, I’d have to wait for the fall enrollment period to get on a Part D prescription drug plan. Could you explain what steps I should be taking? Thank you, Toni.

– Cameron from Lubbock, Texas

Hi Cameron,

Indeed, you’ll have to wait until the open enrollment period for Medicare, which spans from October 15 through December 7, to apply for a Medicare Part D plan or transition from Medicare to a Medicare Advantage HMO/PPO plan that includes prescriptions. Your doctor’s office was correct in charging you $200 per dose for Shingrix, as the shingles vaccine is covered at no additional cost with a Part D plan.

Your experience demonstrates the importance of enrolling in a Medicare Part D plan at the same time as initial Medicare enrollment. The Inflation Reduction Act, which took effect on January 1, 2023, eliminated all out-of-pocket costs for vaccines recommended for adults by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. However, to get these vaccines at no cost, those on Medicare must sign up for a Medicare Part D plan.

In the 2026 Medicare & You handbook, page 50 under “Preventive service: Shots (or vaccines),” explains what Part B covers:

– Flu shots (page 41)

– Hepatitis B shots (page 42)

– Pneumococcal shots (page 48)

Enrolling in a stand-alone Medicare Part D prescription drug plan, with or without a Medicare supplement, or a Medicare Advantage plan with Part D is crucial. One of the reasons is the coverage of the shingles shot with a $0 copay. If eligible, Americans should sign up for a Medicare Part D plan.

Those enrolled in a Medicare Part D plan can get their shingles vaccine at either their pharmacy or doctor’s office. If you’re having difficulty affording the Medicare Part D prescription drug premium, you might be eligible for Medicare’s Extra Help program. This program helps individuals with limited income and assets cover premiums and out-of-pocket costs for Part D drug coverage.

Flu, hepatitis and pneumonia shots are covered under Medicare Part B (not a Medicare Part D plan), according to the handbook. As long as the doctor or other healthcare provider accepts Medicare assignment, those on Medicare may not have to pay anything for the shot. It’s crucial to always confirm that your doctor is accepting Medicare assignment.

As stated under “Important!” on page 50 of the handbook, Medicare Part D generally covers all other adult immunizations recommended by the Advisory Committee on Immunization Practices. These prevent diseases like shingles, tetanus, diphtheria and pertussis, and respiratory syncytial virus at no additional cost. If your shot isn’t listed on your plan’s drug list, the handbook advises asking for a coverage exception and discussing with your doctor which vaccines are suitable for you.

Remember, what you don’t know about Medicare can indeed harm you!

Toni King is an author and columnist specializing in Medicare, Social Security, and long-term care issues. She has spent almost three decades as a leading salesperson in the field. If you have any questions about Medicare, email info@tonisays.com or call 832-519-8664. Sign up for the Toni Says newsletter at tonisays.com to stay informed about changes in Medicare.