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.
Does Medicare cover the shingles vaccine?
Medicare Prescription Drug Plans and Medicare Advantage plans that provide prescription drug coverage generally cover all commercially available vaccinations. These plans will cover the vaccination medication and the administration of the shot by your doctor or physician. Depending on your plan benefits, you may have to pay a copayment or coinsurance amount. Make sure to follow your plan’s guidelines for this vaccination to be covered.
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.
Does Medicare Pay for Shingles Vaccine
Medicare part B does NOT cover shingles vaccination. Part D covers it as a prescription drug (even though it is a preventive vaccine). If your Medicare advantage plan covers part D (drugs) then the shingles vaccine is covered. Your copay may vary from plan to plan. CDC determines the cost of the vaccine including the administration fee is around $190 (2013 price). The copay one has to pay may vary from $60 to 80 to 100. If you have a Medigap (supplemental coverage) policy you may avoid the copay also. Check with your Medigap policy administrator.
Shingles Vaccine Medicare: Insurance Coverage Information
Merck does not warrant or guarantee that ZOSTAVAX is covered by your insurance plan, or that following these steps will result in you or your doctor receiving reimbursement, or that any reimbursement amount you receive will cover your expenses. Merck is not responsible for any action that you or your health care professional take in seeking reimbursement. You or your health care professional should contact your plan directly to ensure that you have the most accurate and timely information on reimbursement, patient out-of-pocket costs, and applicable billing procedures as your coverage status can change.
Does Medicare cover the vaccine for shingles?
If you have Medicare Part D, the optional prescription drug benefit, your shingles vaccine should be covered but the process may be more complicated that filling a prescription for a medication. Your Part D plan will pay for the vaccine, and for its administration by your doctor or other health care provider. Before you get a vaccination, you should check with your Part D plan to see where you can get your shot at the lowest cost. You typically pay the least for your shingles shot if you are vaccinated at: a pharmacy that is in your drug plan’s network; or a doctor’s office that: