Medicare: Flu Shots Coverage

Medicare Part B covers 100% of the costs associated with receiving both standard and preferred influenza vaccines as long as you receive your vaccine from a participating health care provider. Coverage applies at least once per flu season and may apply to additional shots if they are deemed medically necessary.

Read below for more information on how and when Medicare covers flu shots for seniors plus what steps you need to take to make sure you are covered once you become eligible for Medicare.

On This Page

• 

  Does Medicare Cover Flu Shots?

• 

  How Much Is a Flu Shot With Medicare?

• 

  How To Apply for Medicare Part B Before a Flu Shot

• 

  FAQs

Does Medicare Cover Flu Shots?

Medicare provides coverage for flu shots including the standard Fluzone Quadrivalent vaccine and three types of preferred flu shots: Fluzone High-Dose Quadrivalent, Flublok Quadrivalent and Fluad Quadrivalent. Preferred flu vaccines are recommended for people over the age of 65.^[1]

Your Medicare health insurance will generally cover one shot per flu season, although it may cover multiple flu shots per season if a doctor determines that they are medically necessary.^[1] “Flu season” doesn’t have an exact definition but it generally occurs during the fall and winter, potentially beginning as early as October and ending as late as the following May.^[2]

What Part of Medicare Covers Flu Shots?

Flu shots are covered by Medicare Part B, which is also known as medical insurance. Part B predominantly covers outpatient medical care such as doctor’s visits and preventive services like screenings or vaccines. In addition, Medicare Part B includes coverage for the following:^[3][4]

• Home health care
• Durable medical equipment such as wheelchairs and walkers
• Clinical research
• Ambulance services
• Mental health care
• Prescription drugs that aren’t self-administered

Meanwhile, flu shots should also be covered by Medicare Advantage plans, also known as Medicare Part C, since these plans offered by private health insurance companies generally include all of the parts of Original Medicare. However, Medicare Advantage plans tend to have more limited networks than Original Medicare and your carrier could require you to receive your shot from an in-network provider.

How Much Is a Flu Shot With Medicare?

You won’t have to pay anything when you get a seasonal flu shot from a medical provider who accepts assignment, which means they don’t charge more for covered services than the preapproved amount that Medicare agrees to pay.^[1]

Keep in mind that medical providers are required to accept assignment for the flu shot itself but may charge above the Medicare-approved amount for associated administration fees.^[5]

As a result, if your doctor charges an administration fee whenever you get vaccinated against the flu, you could have to pay the difference between the Medicare-approved fee amount and the amount your doctor actually charges.

How Much Is a Flu Shot Without Insurance?

Flu shot prices are fairly stable if you don’t have Medicare or some other type of health insurance but may vary slightly depending on your location and the pharmacy you select. As an example, you can view the below table for a rundown of the most common retail prices for preferred and standard-dose flu vaccines among various pharmacies in Costa Mesa, California, according to GoodRx.

How To Apply for Medicare Part B Before a Flu Shot

In order to enroll in Medicare, you will need to fill out and submit an application on the Social Security Administration website. You have the option to apply for Medicare Parts A and B separately, which may be necessary depending on your circumstances.

For example, once you become eligible for Medicare, usually by turning 65 years old, you will be automatically enrolled in both Parts A and B if you have received Social Security or Railroad Retirement Board benefits for at least four months. However, if you have been approved for these benefits but did not start receiving them at least four months before turning 65, you will only be automatically enrolled in Part A, meaning you must sign up for Part B separately.^[10]

If you have to manually sign up for Medicare, then you will generally need to do so during your initial enrollment period, which begins three months before the month you turn 65 and ends three months after the month you turn 65.^[11]