Does Medicare Cover COVID-19 Vaccines?

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.

Medicare also overs COVID-19 testing, treatment and other related services.

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 $1,600 per benefit period in 2023. 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 Jan. 24, 2022, the FDA announced that due to the spreading of the Omnicron variant, bamlanivimab and etesevimab — types of monoclonal antibody treatment that’s delivered to patients through an IV infusion —  are no longer authorized in any U.S. region.

Some types of monoclonal antibodies are still available under specific conditions. Refer to the U.S. Centers for Medicare & Medicaid Services for updates on coverage and access to monoclonal antibodies.

If you do qualify for a monoclonal antibody treatment that is approved by the FDA — there will be no copay or deductible.

Your COVID-19 vaccine is covered by Part B, which is included in Medicare Advantage.

Due to potential blood clots following the administration of the Johnson & Johnson vaccine, the CDC will only approve the vaccination in specific instances.

You don’t have to pay out of pocke for your first shot, second shot or any recommended booster shot for the COVID-19 vaccine. This means you don’t pay a deductible, copayment or coinsurance 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.

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.”

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.

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.