Does Medicare cover the RSV vaccine?

RSV- Respiratory Syncytial Virus (sin-SISH-uhl) is a respiratory virus associated with mild cold-like symptoms. Individuals who aged 65 and older face a heightened risk of severe health complications due to RSV. Fortunately, protection is available through the RSV shot, and Medicare Part D provides coverage for RSV vaccines.

Medicare Coverage Details:

  • RSV shot coverage is included under Medicare Part D, specifically under prescription drug coverage.
  • Notably, Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) do not cover the RSV vaccine shot.

Costs in Original Medicare:

  • Individuals who enrolled in Medicare Part D typically incur no out-of-pocket expenses for most vaccines, including the RSV shot.
  • Original Medicare, comprising Parts A and B, does not handle the cost of the RSV vaccine shot, emphasizing the importance of Part D for this vaccination.

Comprehensive Vaccine Coverage:

  • Part D extends coverage to all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
  • ACIP’s recommendations encompass various vaccines, such as those for RSV, shingles, whooping cough, and more.
  • Enrollees in Part D are exempt from copayments or deductibles for vaccines endorsed by ACIP.

In conclusion, Medicare Part D plays a pivotal role in facilitating access to the RSV vaccine shot for individuals aged 65 and older, offering comprehensive coverage and financial benefits that contribute to public health and well-being.

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