If your health care professional cannot submit and process a claim for your Medicare Part D plan, and the vaccine is covered, you may be required to make an upfront payment and then submit your claim for reimbursement. Please note that even if you have some coverage for ZOSTAVAX, the amount reimbursed to you by your Part D plan may be less than the amount of your upfront payment. It is a good idea to contact your Medicare Part D plan to learn what coverage is available to you and what process your plan has for submitting a claim.
Does Medicare pay for the Shingles vaccine?
You are probably wondering, since the shingles virus comes from the same virus as chickenpox, are the symptoms the same as chickenpox? Shingles usually starts with a headache and then a rash on a band or section of skin, typically on one side of the face or body. Symptoms can also include general achiness and fatigue, fever and chills. The rash then turns into clusters of blisters, which fill with fluid and crust over. Itching can also be a symptom. Shingles can be very painful. The virus travels along nerve pathways, causing inflammation and damage. The pain tends to be more severe and last longer in older people. In the worst cases, the shingles virus can cause blindness, if it infects the eyes or the area around your eyes, as well as hearing problems, brain inflammation (encephalitis) or death. Mild scarring usually occurs where shingles appear on the skin. If you believe you may have shingles you should seek medical attention promptly.
Why won't Medicare pay for the Shingles Vaccine which is very painful for the elderly?
It only came out in 2006 (and Medicare’s budget was already set, so that might be the problem, budgets are set way in advance) Medicare started covering the drug in January of 2007, but not as a regular vaccination but as a part of the prescription drug plan or the D part of medicare And it is definitely cost effective for them to pay for the vaccine as opposed to the costs of treatment of shingles, And as someone who got shingles in the left eye 2 weeks before they announced the vaccine I can attest to the fact regardless of the cost, if you had chicken pox before you should definitely get the vaccine now! Not getting the vaccine should not be an option for you. Even with Medicare paying for all the pain medicine the costs of having shingles is far greater than the cost of the vaccine. And the pain is about as painful as you can get. Luckily I caught it early and my ophthalmologist prescribed antiviral for the eye but now a year later, i still get those nerve pains every now and then and I would pay anything not to get them And you should contact AARP and your congressman about this too. More people clamoring for the coverage as a regular vaccine will eventually make it happen thru the appropriations process.
Does Medicare Pay for Shingles Vaccine
No, it won’t. In general, Medicare doesn’t do a very good job of covering preventive medical care . The only immunizations it covers are a yearly flu shot, the pneumonia vaccine, and the vaccine against hepatitis B (if you are at medium or high risk for contracting the disease).
Shingles Vaccine Medicare Coverage and Cost Information
Shingles, or Herpes zoster, is caused by the same virus (varicella zoster, VZV) that causes chickenpox. It is characterized by pain, red rash, and painful fluid filled blisters. The virus is never eliminated from the body, but instead lives in a dormant stage in the nervous system. The virus can be reactivated when the person is subject to prolonged stress, or through the treatment certain illnesses such as cancer. Getting vaccinated with Zostavax, a chickenpox booster, can help prevent it’s painful occurrence, as well as reduce the risk of complications such as posterherpetic neuralgia.
Shingles Vaccine Protects Seniors and Is Covered by Medicare
Shingles Overview Shingles, also known as herpes zoster, is a burning, blistering, often excruciating skin rash that affects about 1 million Americans each year. The same virus that causes chickenpox causes it. What happens is the chickenpox virus that most people get as kids never leaves the body. It hides in the nerve cells near the spinal cord and, for some people, emerges later in the form of shingles.
Medicare Insurance: Medicare and the Shingles Vaccine (Zostovax)
As with any medication, check with your Part D plan to confirm that the Shingles vaccine (Zostovax) is part of their formulary. Many Part D plans have a deductible and most have copays. The Shingles vaccine is expensive. It is a higher tier drug on most plans, around $170 retail on average, so also check your cost. Most Part D plans have agreements with their network participating pharmacies to administer the Shingles vaccine at the pharmacy for a reduced charge (similar to the flu vaccine). Check with your Part D plan~Check with your pharmacy BEFORE getting the injection.