Paying for Vaccines

All Health Insurance Marketplace plans and most other private insurance plans must cover certain vaccines without charging a copayment or coinsurance when provided by an in-network provider. This is true even for patients who have not met a yearly deductible. Doses, recommended ages, and recommended populations for vaccinations vary. The following vaccines are usually covered by health insurance:

• COVID-19
• Haemophilus influenzae type b
• Hepatitis A
• Hepatitis B
• Herpes Zoster
• Human Papillomavirus
• Influenza
• Measles, Mumps, Rubella
• Meningococcal
• Pneumococcal
• RSV
• Tetanus, Diphtheria, Pertussis
• Varicella

Check with your insurance provider for coverage details. Under the Affordable Care Act, insurance plans that cover children allow parents to add or keep adult children on their health insurance policy until they turn 26 years old.

Medicare Part B plan will pay for the following:

• COVID-19 vaccines
• Hepatitis B vaccines for persons at increased risk of hepatitis
• Influenza (flu) vaccines
• Pneumococcal vaccines
• Vaccines directly related to the treatment of an injury or direct exposure to a disease or condition, such as rabies and tetanus

Medicare Part D plans make all adult vaccines recommended by the Advisory Committee on Immunization Practice (except those covered by Part B) available at no cost, including:

• RSV
• Zoster (shingles) vaccine

Even if a particular drug plan’s formulary doesn’t list all Part D vaccines, it must provide access when a physician prescribes a Part D vaccine.

Contact your plan to find out about coverage.