Does Medicare Cover the Tdap Vaccine?
Tdap is a vaccine that protects against tetanus, diphtheria and pertussis. Starting January 1, 2023, Medicare Part D and Medicare Advantage plans will cover Tdap vaccine costs. This means you'll have no deductible or cost-sharing. Original Medicare (Part A and Part B) does not cover the cost of the Tdap vaccine.
- Written by Christian Simmons
Christian Simmons is a writer for RetireGuide and a member of the Association for Financial Counseling & Planning Education (AFCPE®). He covers Medicare and important retirement topics. Christian is a former winner of a Florida Society of News Editors journalism contest and has written professionally since 2016.Read More
- Edited ByLee Williams
Senior Financial Editor
Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.Read More
- Reviewed ByAflak Chowdhury
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- Published: May 17, 2021
- Updated: June 23, 2023
- 3 min read time
- This page features 12 Cited Research Articles
- Edited By
Medicare Benefits for Tdap Vaccine
You could also choose a Medicare Advantage plan, which covers the Tdap shot, as an alternative to Original Medicare. Medicare Advantage covers everything included in Medicare Part A and Part B along with additional benefits.
In previous years, your out-of-pocket costs for the Tdap shot would vary depending on your Part D or Medicare Advantage plan. The Inflation Reduction Act will make your Tdap shot free in 2023 — if you have any Medicare drug coverage plan through Part D or Medicare Advantage.
This new vaccine coverage determined that Part D-covered adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) will no longer have a deductible or cost-sharing. The Tdap shot is on ACIP’s list of vaccine reccomendations and guidelines.
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.
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% 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.
12 Cited Research Articles
- U.S. Centers for Disease Control and Prevention. (2022, October 5). Reduced Drug Prices, Enhanced Medicare Benefits Under the Inflation Reduction Act Frequently Asked Questions (FAQs). Retrieved from https://www.cms.gov/files/document/10522-external-faqs-about-inflation-reduction-act.pdf
- 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
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