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Does Medicare Cover The Shingles Vaccine?

Shingles is a viral infection that is in the same family as herpes and chicken pox. It is actually a secondary infection from the same virus that actually causes chicken pox, the varicella-zoster virus. Even if you had chicken pox many years ago the virus is still in your body. It usually lives in your nerve tissue for a long time. It can resurface as shingles later on in life. The symptoms of shingles are a painful, itchy rash. It doesn’t really look or feel like chicken pox. You may also have general fatigue and a fever, and a general feeling of malaise. Pain is the primary symptom and depending on the case it can be minor or intense.

Some people have mistaken it for symptoms having to do with heart or kidney problems because it is so intense. It typically happens around your abdomen but it can also happen around your eye or neck. You should always go to the doctor when it is around your eye because that can actually damage your eye! Otherwise, you should know that shingles can be prevented with a vaccine. If you do get an outbreak, going to the doctor as soon as possible and getting treatment will lower the severity of your outbreak.

Does Medicare Cover the Shingles Vaccine?

Unfortunately, the “Zostavax” as it is commonly referred as, is not covered under Medicare Part B, the part of Medicare that covers outpatient procedures like vaccines. However, if you have Medicare Part D, the part that covers prescription drugs, you may have coverage for the vaccine. This plan covers most vaccines that you would want to get, so that is helpful. This type of Medicare is optional but it helps you pay for all prescription drugs.

Another way to get coverage would be to get a Medicare Advantage Plan, which would cover you for everything in Medicare Parts, A, B & D. This is also known as Medicare Part C. You can get all sorts of extra coverage from this type of Medicare plan and you will probably have to pay more for it. This will cover all sort of things but each plan is different so you would have to make sure your plan will cover that.

How Does the Vaccine Work?

Like many vaccines, the Zostavax contains an weak form of the virus that gets injected right into your body. This activates your immune system so it knows to fight the virus if it sees it! It only reduces your chance of shingles by 38%, but if you do get shingles it tends to reduce the severity of your case. Since mostly older people get shingles, the vaccine is primarily recommended for people over the age of 50. If you have an immune system deficiency, you should not get this vaccine and talk to your doctor about preventative measures you could take so you will be less likely to get shingles.

So, some parts of Medicare do cover this vaccine, which is a good idea to get for anyone over the age of 50.