Medicare Covers Your Vaccinations

Michael T Braden August 28, 2024 MEDICARE NEWS

Braden Medicare Insurance's Poster Showing a Female Medicare Beneficiary Sporting a Band-Aid with the caption "Covered Vaccines For All Medicare Part B Enrollees.

MEDICARE PART D COVERS YOUR VACCINATIONS

The purpose of this article is not to be a statement for or against vaccines in any way, shape, or form. To deliver information, I respectfully do not care if you are pro-vaccine or anti-vaccine. Neither viewpoint is the reason why I decided to write the article. This article offers tips, tricks, and reminders to help seniors and Medicare beneficiaries understand how to receive vaccines at no cost. It's as simple as that.

Everyone enrolled in any Medicare Plan must be enrolled in Medicare Part B. However, your vaccinations are paid for using your Medicare Prescription Drug Plan benefits, Medicare Part D.

WHERE YOU SHOULD GO TO GET VACCINATION SHOTS

As Fall slowly begins, it is a reminder to start thinking about receiving your 2024 Influenza (Flu Shot) Vaccine, and possibly others. This year, things are a little different because Medicare changed its policy and stance on covered vaccines on January 1, 2023. This new rule allows Medicare Beneficiaries to receive free vaccinations for all vaccines recommended by the CDC.

During the Pandemic, nobody paid for COVID shots, and Medicare always covered Flu Shots, but there are a few more items you may not be aware of.

NEW COVID BOOSTER

I suggest everyone considering the new COVID-19 booster speak with their General Practitioner, Primary Care Doctor, or Nurse Practitioner before scheduling a vaccine.

According to the article, both of the latest COVID-19 booster shots that were made available last month are manufactured only by Pfizer and Moderna. It is recommended that if you get a booster, get one from the same manufacturer you used for your initial COVID-19 shots.

Here is the troubling part of the article for me. The Pfizer Vaccine reportedly tested only the new Booster in mice, and the Moderna Vaccine was given only to 10-50 humans in its tests. This does not mean that the new Booster released on September 12, 2023, is unsafe. It only suggests that no company can say with certainty how effective it is, or how effective it will be against all existing and future COVID-19 variants.

From everything I have read to date about the new Booster, it is purported to prevent the need for any long-term hospitalization for anyone diagnosed with COVID and to lessen the severity of the effects if you are diagnosed, which is excellent. But to be clear, this new Booster, which is virtually untested and seems to me to have been rushed to market by the Government, will not keep you from contracting COVID-19, and, sadly, it seems the Government, FDA, and CDC are rushing things unnecessarily. The only question is why? Lastly, if you are in a high-risk groupCOVID-19 for contracting COVID-19, or due to a pre-existing condition that leaves you at higher risk for contracting COVID, definitely contact your Doctor and see what they say.

I am not a Medical professional, and for the record, up until this new Booster, I have received every other COVID Booster. I have never been diagnosed with COVID-19. I think more data comes in every day that warrants questioning the accuracy of claims previously made by Pfizer, Moderna, Bio-Tech, Johnson & Johnson, the FDA, the CDC, and the White House. To me, I have not read anything suggesting you would be harmed by receiving the Booster. I do not want anyone to think you are 100% protected against any of the COVID variants we have seen so far.

SHINGLES VACCINE (Herpes Zoster)

Shingles is common—almost 1 in 3 people will get it in their lifetime. The good news is that the shingles vaccine, called Shingrix®, is more than 90% effective at preventing shingles.

RSV VACCINE

A respiratory syncytial virus (RSV) vaccine protects against infection by the respiratory syncytial virus. The RSV vaccines Arexvy and Abrysvo were approved for medical use in the United States in May 2023.

PNEUMOCOCCAL PNEUMONIA VACCINE

Pneumococcal disease (noo-muh-KOK-uhl) causes thousands of infections every year in the United States. It’s more common in children, but it’s most likely to cause serious complications in adults. The good news is that pneumococcal vaccines can help prevent the disease.

There are three types of pneumococcal vaccines (PCV13, PCV15, and PCV20). Recommendations vary by age and medical status.

PCV15 or PCV20

•  Adults 19 through 64 years old with certain medical conditions or other risk factors who have not already received a pneumococcal conjugate vaccine should receive either:

• a single dose of PCV15 followed by a dose of pneumococcal polysaccharide vaccine (PPSV23), or

• A single dose of PCV20.

•  Adults 65 years or older who have not already received a pneumococcal conjugate vaccine should receive either:

  
  

• a single dose of PCV15 followed by a dose of PPSV23, or

• A single dose of PCV20.

  
  

PCV15 or PCV20

•  Adults 19 through 64 years old with certain medical conditions or other risk factors who have not already received a pneumococcal conjugate vaccine should receive either:

• a single dose of PCV15 followed by a dose of pneumococcal polysaccharide vaccine (PPSV23), or

• A single dose of PCV20.

•  Adults 65 years or older who have not already received a pneumococcal conjugate vaccine should receive either:

• a single dose of PCV15 followed by a dose of PPSV23, or

• A single dose of PCV20.The purpose of this article is not to be a statement for or against vaccines in any way, shape, or form. To deliver information, I respectfully do not care if you are pro-vaccine or anti-vaccine. Neither viewpoint is the reason why I decided to write the article. This article is to share tips and tricks. It's a simple reminder to keep Seniors and Medicare Beneficiaries aware of the proper way to receive vaccines at no cost. Simple as that.

HEPATITIS A

Hepatitis A is a severe disease that was once more common in the United States. In the 1980s, the United States saw as many as 30,000 cases a year. Thanks to the vaccine, hepatitis A cases in the United States have dropped by 95%.

Two vaccines protect against hepatitis A:

• The hepatitis A vaccine protects infants, children, and adults from hepatitis A

• The hepatitis A and B combination vaccine protects adults from both hepatitis A and hepatitis B

HEPATITIS B

Hepatitis B is a common disease in the United States. The good news is that the hepatitis B vaccine protects more than 90% of people.

2 vaccines protect against hepatitis B:

•  The hepatitis B vaccine protects infants, children, and adults from hepatitis B

•  The hepatitis A and B combination vaccine protects adults from both hepatitis A and hepatitis B 

TETANUS & DIPHTHERIA

Tdap. This shot protects against tetanus, diphtheria, and whooping cough (pertussis). The CDC recommends getting a Tdap or TD booster every 10 years. 

THE ONLY PLACE TO GET YOUR VACCINES FOR FREE

Since January 1, 2023, when the new Medicare Vaccination coverage kicked in, the only place you can get Vaccinations for the above-listed vaccines is by going to the "Preferred Pharmacy" for your individual Medicare Part D Prescription Drug Plan. This should be the same pharmacy where you fill your prescriptions.

Many pharmacies allow you to walk in and proceed to the Pharmacy without an appointment. After speaking with several pharmacies, we suggest that you either enroll online on the Pharmacy Stores website or call the pharmacy to make an appointment. Please remember to bring your ID and Part D Plan card when you go. Pick up your regular prescription Medications.

Effective January 1, 2025, you will be able to get your vaccine at ANY of your Medicare Part D plans "In-Network" pharmacies, not just your preferred pharmacies.

WHERE THEY CAN GIVE YOU A VACCINE, BUT YOUR PART D PLAN PROBABLY WON'T PAY FOR IT

ANY PHARMACY CAN GIVE YOU A SHOT. HOWEVER, THE ONLY WAY YOU WILL NOT HAVE TO PAY FOR THEM IS TO GET THEM AT THE PREFERRED PHARMACY FOR YOUR PARTICULAR PLAN!

If you are at your doctor's office and they ask whether you want or need a vaccine, politely decline and go to your Part D Plan's Preferred Pharmacy. If you get vaccines at the doctor's office, they will bill you under Part B. Medicare Part D is the only way to receive these vaccines at no cost.

If you are at the Grocery Store, Costco, or Sam's Club and hear an announcement that they are administering Flu Shots, do not get one. Go home, call your Preferred Part D Plan Pharmacy, and make an appointment.

ASK YOUR DOCTOR AND PHARMACY FOR A LIST OF ALL OF YOUR VACCINES OVER THE PAST 5-10 YEARS

Most people do not remember the last time they had a Tetanus or a Pneumonia shot. Please ask your doctor and pharmacist for any records to ensure you are up to date. Pneumonia vaccines are good for 5 years. The Shingrix vaccine for Shingles is a 1-time, 2-part vaccine. Influenza Shots are every Fall/Winter. COVID-19 boosters depend on when updated Boosters become available. Please ask your Doctor or Pharmacist if you need anything, as they say, "an ounce of prevention is worth a pound of cure."

Please call us at www.bradenmedicare.com or (480) 225-1393, or email me at mike@bradenmedicare.com anytime. Let us know how we can help you. Remember, anyone and everyone is welcome to ask us any question, any time.