If you are planning on getting your shingles shot here are some important tips you need to know.
Make a plan to get 2 doses
- You can get Shingrix at your doctor’s office or pharmacy. Talk to your doctor or pharmacist about getting Shingrix.
- Shots are NOT free! Call your Medicare Part D plan ahead of time to see how much the vaccine is going to cost you.
- Plan to get your second dose of Shingrix 2 to 6 months after your first dose.
Unlike most other common vaccines, which are covered under Part B, Medicare coverage for the shingles shot is only available if you’re enrolled in a stand-alone Part D drug plan or a Medicare Advantage plan that includes Part D drug coverage.
Medicare requires all Part D drug plans to cover the shingles vaccine, so if you’re enrolled in a plan you shouldn’t have difficulty obtaining the shot. But there are some pitfalls to watch out for in terms of paying for it, depending on where you receive it:
If you’re vaccinated in a pharmacy, make sure it’s one that’s in your plan’s pharmacy network. Otherwise, the shot will cost more than your plan’s normal copay, maybe even full price.
If you’re vaccinated in a doctor’s office, make sure that the doctor can bill your plan directly through its computer billing process, or can work with a pharmacy in your plan’s network that can also bill the plan directly. Otherwise, you’ll have to pay the whole bill upfront and then claim reimbursement from your plan.
To be on the safe side: Call your plan in advance and ask which doctors or pharmacies in your area you should use to receive the shingles shot at the plan’s normal copay.