Does Medicare Cover the Tdap Vaccine?

Original Medicare will not pay for you to get a Tdap shot, but the vaccine will be covered under a Medicare Part D plan, which is an optional benefit that covers prescription drugs.

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. 

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.

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.

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.

A 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.

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.