Vaccines under Medicare Part D

Most vaccines are covered under Medicare Part D and should be administered at a pharmacy. Most medical providers are not set up to bill Medicare Part D. If a provider administers a Part D vaccine in a clinic or other provider facility, the patient will typically have a higher bill than if had they received the same vaccine at a pharmacy.

Note: Providers can administer and bill certain vaccines covered under Part B. This includes vaccinations for influenza, pneumococcal, and Hepatitis B (if intermediate to high risk). Part B also covers vaccines if the patient is exposed to a virus or disease (e.g., tetanus vaccination is covered if the patient stepped on a rusty nail, rabies vaccination is covered if bitten by a dog, etc.).