Yes, Medicare covers one flu shot per year free of charge and another shot if it is medically necessary. The cost does not apply to a person’s deductible, and they will not have any copayment or coinsurance.
Medicare pays healthcare professionals directly when they administer flu shots. The healthcare practice views this payment as full reimbursement.
This article explains which parts of Medicare cover the flu shot and how a person can ensure it comes at no additional cost to them.
Medicare covers the entire cost of one flu shot per year, per the Centers for Medicare & Medicaid Services (CMS).
Both Medicare Part B (medical insurance that is part of Original Medicare) and Medicare Advantage (Part C) plans provide this coverage.
However, Medicare does not cover the cost of a flu shot from every healthcare practice. The shot needs to come from healthcare professionals who agree to accept Medicare.
For some people, doctors recommend additional flu shots. Medicare may cover the cost of these shots if a healthcare professional deems them medically necessary.
For these people, Medicare will cover two shots over a single calendar year.
For instance, if a person receives a flu shot in January, they may be eligible for another in October of the same year, and Medicare may cover the cost of the second shot, according to Medicare Interactive.
A person should ask their doctor for more information about recommended additional doses.
Read about the benefits and risks of flu shots.
If a person has Medicare Part B, a Medicare Advantage plan, or private health insurance, they can get a flu shot for free.
The Affordable Care Act (ACA) requires insurance companies to cover the cost of the flu shot without charging a copayment.
A person should check with the site providing the shot to make sure it accepts assignment from Medicare or accepts Medicare Advantage plans. People with private insurance should check their plans to make sure they can get the shot from a particular location for free.
Some insurance plans cover the shot only if a person receives it from their doctor. Other plans provide coverage if the shot comes from certain other locations as well.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
What is the difference between the regular flu shot and the senior flu shot?
The high dose flu vaccine contains four times the antigen as standard flu vaccines. The high dose vaccine is recommended for people ages 65 years and older. Studies have shown it to be
How much is a flu shot without insurance?
Without insurance, a flu shot costs $20 to $70. However, people without insurance may be able to get free or low cost vaccines from the following
- their health professional
- pharmacies (visit vaccines.gov to make an appointment)
- health centers supported by the Health Resources & Services Administration
- community organizations, employers, and schools
Medicare covers one flu shot per year. Before having a flu shot, a person should check whether the shot provider accepts a Medicare-approved payment.
If a doctor recommends additional shots, Medicare may cover these as well. However, a person should double-check this before getting a second shot.
People with Medicare Advantage or private health insurance plans may have the option to get the flu shot for free. A person should check with their plan and healthcare professional to make sure their plan will cover the cost.
