Does Medicare Cover the Tdap Vaccine?
Tdap is a vaccine that protects against tetanus, diphtheria and pertussis. Original Medicare (Part A and Part B) does not cover the cost of the Tdap vaccine, but Medicare Part D prescription drug plans do. Some Medicare Advantage plans (Part C) that include prescription drug benefits may also cover Tdap shots.
Medicare Benefits for Tdap Vaccine
Part D is provided through private insurers and plans vary. Your cost will depend on your specific plan.
The shot could also be covered through a Medicare Advantage plan if it offers or includes Part D coverage. Advantage plans are also provided through private insurers and cover everything included in Medicare Part A and Part B along with additional benefits. Similar to Part D, cost and coverage vary by your specific plan.
What Is the Tdap Vaccine and Who Needs It?
The Tdap vaccine protects against a group of very serious bacterial infections. Diphtheria causes a membrane-like covering in the throat that can lead to paralysis and death, tetanus causes painful muscle-tightening such as lockjaw, and pertussis, better known as whooping cough, is a very contagious respiratory tract infection.
Everyone should receive a Tdap vaccine at some point in their lives to prevent these infections. Most people get the shot in their childhood. Adults should also receive a booster shot once every 10 years, and pregnant women should get it as well each time they are pregnant.
- Pain, redness or swelling where shot was given
- Mild Fever
Tdap shots are both effective in preventing these bacterial infections and safe to use. There is the possibility of side effects, but they are typically mild and will most likely go away on their own. The most common reaction is pain, redness or swelling at the site of injection, but this is rarely severe.
Does Medicare Cover Tetanus Shots?
If you need a tetanus shot because of a contaminated injury, you will likely be able to use your Medicare Part B benefits to cover the cost because the shot would be considered medically necessary. But Original Medicare will not help pay for the tetanus shot if you need it only as a booster shot or as a regular vaccination.
Medicare Part D or a Medicare Advantage plan that includes prescription drug coverage will also pay for a tetanus booster shot.
Tetanus is a bacterial infection that causes painful muscle contractions, including the tightening and locking of the neck muscles as well as lockjaw. People can be exposed to tetanus bacteria through breaks in the skin.
- Crash injuries
- Injuries with dead tissue
- Puncture wounds
- Wounds contaminated with dirt, feces or saliva
About 11 percent of tetanus cases reported in recent years ended in death, according to the Centers for Disease Control and Prevention.
There are about 30 cases of tetanus each year, almost all of which are among people who did not get their recommended vaccinations.
11 Cited Research Articles
- Centers for Disease Control and Prevention. (December 2020) Tetanus. Retrieved from https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html
- Centers for Disease Control and Prevention. (2020, September 9). Diphtheria, Tetanus and Pertussis Vaccines. Retrieved from https://www.cdc.gov/vaccinesafety/vaccines/dtap-tdap-vaccine.html
- Centers for Disease Control and Prevention. (2019, August 2). Vaccine (shot) for Tetanus. Retrieved from https://www.cdc.gov/vaccines/parents/diseases/tetanus.html
- Centers for Disease Control and Prevention. (2019, February 28). About Tetanus. Retrieved from https://www.cdc.gov/tetanus/about/index.html
- Centers for Disease Control and Prevention. (2019, February 28). Causes and Transmission. Retrieved from https://www.cdc.gov/tetanus/about/causes-transmission.html
- Centers for Disease Control and Prevention. (2019, February 28). Symptoms and Complications. Retrieved from https://www.cdc.gov/tetanus/about/symptoms-complications.html
- Centers for Disease Control and Prevention. (2019, February 28). Tetanus. Retrieved from https://www.cdc.gov/tetanus/index.html
- Department of Health and Human Services. (2014, August 11). What is Medicare Part C? Retrieved from https://www.hhs.gov/answers/medicare-and-medicaid/what-is-medicare-part-c/index.html
- Centers for Medicare and Medicaid Services. (n.d.). Drug Coverage (Part D). Retrieved from https://www.medicare.gov/drug-coverage-part-d
- Centers for Medicare and Medicaid Services. (n.d.). Tdap shots. Retrieved from https://www.medicare.gov/coverage/tdap-shots
- Centers for Medicare and Medicaid Services. (n.d.). What Part B Covers. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-b-covers