Does Medicare Cover COVID-19 Vaccines?
You pay nothing for your COVID-19 vaccination so long as you are enrolled in Medicare Part B or a Medicare Advantage plan. You also do not have to pay for the COVID-19 vaccination if you only have Medicare Part A, but the provider that gives you the shot may charge you an administration fee.
Medicare Will Cover Your COVID-19 Vaccination
COVID-19 vaccination costs are covered completely under Medicare Part B medical insurance. Part B covers medical costs such as doctor visits and other medical services. The cost of the vaccine will not be applied to your Part B deductible and you will not have to pay coinsurance.
Medicare Advantage plans are sold by private insurers whose policies are approved by Medicare. These plans are required to cover all costs covered by Original Medicare — Medicare Part A and Part B. Because of this, all Medicare Advantage plans are also required to cover all costs of your COVID-19 vaccination.
Medicare Part A covers hospital costs. But if it is the only Medicare part that you have, it will pay for the vaccine. However, you may have to pay an administration fee to the doctor, hospital, pharmacy or other health care provider who gives you your shot.
Does Medicare Cover COVID-19 Testing and Treatment?
Medicare also overs COVID-19 testing, treatment and other related services.
- FDA-approved or FDA-authorized COVID-19 vaccinations
- COVID-19 tests
- COVID-19 antibody tests
- COVID-19 monoclonal antibody treatments
If you have Medicare, you still may have out of pocket costs for COVID-19 treatments and hospitalization. You will have to pay your Medicare Part A deductible of $1,556 per benefit period in 2022. You will also have to pay the standard Medicare costs for extended hospital stays beyond 60 days.
Medicare covers COVID-19 treatments that have been approved by the U.S. Food and Drug Administration.
As of November 2020, Medicare also covers a share of the cost for bamlanivimab — a monoclonal antibody that’s delivered to patients through an IV infusion. While not FDA-approved, bamlanivimab was granted an emergency use authorization by the FDA.
Medicare covers the infusion whether it’s performed in a hospital or some other free-standing medical facility.
Does Medicare Advantage Cover COVID-19 Vaccines?
Your COVID-19 vaccine is covered by Part B, which is included in Medicare Advantage.
- Johnson & Johnson’s Janssen
You don’t have cost-sharing for your first shot, second shot or booster shot for the COVID-19 vaccine. This means you don’t pay a deductible, copayment or coinsurance.
How Do Medicare Recipients Sign Up for a COVID-19 Vaccination?
Pharmaceutical manufacturers and the federal government are distributing COVID-19 vaccines to state and federally approved vaccine centers where you can get your shot.
But every state has set up its own rules on the order in which people can receive their shots. It can be difficult in some states simply to find out when and where you can get the vaccination. The rules may change periodically.
You should contact your state health department — or visit its website — to keep up to date on the latest information about when you’re eligible to get your COVID-19 shot and to sign up for it. In some states, you may be able to sign up for a shot even before you’re eligible.
You may run into trouble trying to get a sign-up website to work or to get an answer on the other end of the line if you call a state or county hotline. Be patient and persistent.
What to Know Before You Go to Get Your Vaccination
A COVID-19 vaccine can help reduce your risk of becoming infected with COVID-19. If you do become infected, the vaccination may make it less severe. COVID-19 vaccines work with your body’s natural defenses to let you build an immunity to the particular type of coronavirus that causes COVID-19.
Make sure you have your red, white and blue Medicare card with you when you go to get your COVID-19 shot. The doctor, hospital, pharmacy or any other health care provider will need it to bill Medicare.
You’ll need your Medicare card even if you are enrolled in a Medicare Advantage plan rather than Original Medicare.
You may have to fill out a form before you get your vaccine. If you have Medicare Part B, leave the line blank or write in “N/A” when the form asks for your “Group Number.”
Avoid COVID-19 Vaccine Medicare Scams
Be aware of possible Medicare fraud and scams when you are signing up for or looking for information about COVID-19 vaccinations.
Medicare consumers have already filed complaints about fraud schemes surrounding COVID-19 vaccine distribution and both Medicare and the Federal Bureau of Investigation have warned Medicare beneficiaries to be on the lookout for scams.
Scammers have used the high demand for vaccine access to try to steal people’s personal information or money from people seeking COVID-19 shots.
- Check your state’s health department website to confirm vaccination sites
- Check www.fda.gov to make sure a promised vaccine has received FDA authorization
- Check with your primary care doctor before scheduling your vaccine appointment
- Never share any personal information with anyone over the phone or internet unless you know them and they are trusted medical professionals
- Review your medical bills, explanation of benefits or your Medicare Summary Notice and check for suspicious items billed to Medicare
If you think you’ve been the victim of a Medicare fraud or scam — whether it involves the COVID-19 vaccines or any other medical service or product — report it immediately to Medicare and law enforcement.
You can call Medicare at 1-800-633-4227 (TTY at 1-877-486-2048) and ask for a customer service representative. You can also call the FBI at 1-800-225-5324 or your local police department or sheriff.
8 Cited Research Articles
- Berg, S. (2021, January 27). How to Help Your Patients Avoid COVID-19 Vaccine Scams. Retrieved from https://www.ama-assn.org/delivering-care/public-health/how-help-your-patients-avoid-covid-19-vaccine-scams
- U.S. Centers for Medicare & Medicaid Services. (2021, January 6). Medicare COVID-19 Vaccine Shot Payment. Retrieved from https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment
- Federal Bureau of Investigation. (2020, December 21). Federal Agencies Warn of Emerging Fraud Schemes Related to COVID-19 Vaccines. Retrieved from https://www.fbi.gov/news/pressrel/press-releases/federal-agencies-warn-of-emerging-fraud-schemes-related-to-covid-19-vaccines
- Cubanski, J. and Freed, M. (2020, December 4). FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment. Retreived from https://www.kff.org/coronavirus-covid-19/issue-brief/faqs-on-medicare-coverage-and-costs-related-to-covid-19-testing-and-treatment/
- O’Brien, S. (2020, October 29). Medicare Will Cover Early Vaccines for COVID. Retrieved from https://www.cnbc.com/2020/10/29/medicare-will-cover-early-vaccines-for-covid-.html
- U.S. Centers for Disease Control and Prevention. (2020, August 6). State and Territorial Health Department Websites. Retrieved from https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Coronavirus Disease 2019 (COVID-19) Vaccine. Retrieved from https://www.medicare.gov/coverage/coronavirus-disease-2019-covid-19-vaccine
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare and Coronavirus. Retrieved from https://www.medicare.gov/medicare-coronavirus