Medicare Advantage Members
Drug Coverage – Part D Vaccine Information
Did you know that you can save money by getting your vaccines in the right location. Most vaccines (and the cost to get them) are covered under your Medicare Prescription Drug (Part D) benefit.
Examples of vaccines covered under the Part D benefit include:
- Zoster (Shingles) vaccine
- Tetanus Diphtheria (Td) vaccine
- Tetanus Diphtheria Pertussis (Tdap)
If you don’t have Quartz Medicare Advantage Part D:
If you didn’t choose to have Part D coverage, that means your Part D vaccines are not covered. However, a few vaccines are covered with Quartz Medicare Advantage Part B. These vaccines may be covered in full and examples include:
- Hepatitis B vaccine (if you are high or moderate risk)
- Influenza vaccine
- Pneumococcal vaccine
- Tetanus vaccines necessary for the treatment of an illness or an injury that has occurred.
Convenient options to receive your Part D vaccines
As of January 2, 2023, Medicare has new vaccine coverage rules. These new changes make getting your vaccines more affordable and convenient. All vaccines for adults that are recommended by the Advisory Committee on Immunization Practices (ACIP) and given in 2023 will have a $0 cost share. It does not matter what benefit stage you are in. For example, you will pay $0 for a Part D vaccine even if your Part D plan benefits have a deductible.
You can get your Part D vaccines at a network pharmacy or doctor’s office. If you choose to get the vaccine in your doctor’s office, you must pay them directly. Most clinics are not able to bill Quartz directly for Part D services. If your clinic is not able to bill Quartz directly for Part D services, submit a Part D prescription drug reimbursement form to Quartz to be reimbursed. Include with the form your receipt of the billing statement. Quartz will fully reimburse you for what the doctor or clinic charges you on your bill.