Does Medicare cover the COVID-19 vaccine?

What does Medicare cover for the COVID-19 vaccine?

Medicare Part B covers FDA-approved and FDA-authorized COVID-19 vaccines as a preventive service. Part B covers the updated COVID-19 vaccines Medicare.gov lists for anyone who has Medicare.

A COVID-19 vaccine helps lower your chances of becoming severely sick from COVID-19 by working with the body's natural defenses to develop immunity (protection) against the virus. Bring your red, white and blue Medicare card when you get the vaccine so your doctor, other health care provider or pharmacy can bill Medicare.

Which COVID-19 vaccines does Part B cover?

Medicare Part B covers the updated COVID-19 vaccines that Medicare.gov lists, and Medicare.gov's COVID-19 vaccine page gives the ages each vaccine is for. Medicare.gov points to CDC.gov to find your vaccination schedule.

What do I pay for the COVID-19 vaccine?

You pay nothing if your doctor or other health care provider accepts assignment for giving you the vaccine. Assignment means your provider agrees to be paid directly by Medicare, to accept the payment amount Medicare approves, and not to bill you for more than the Medicare deductible and coinsurance.

Your provider can't charge you for an office visit or other fee if the vaccine is the only medical service you get. If you get other medical services at the same time you get the COVID-19 vaccine, you may owe a copayment or deductible for those services.

What if I was charged for a COVID-19 vaccine?

If you paid a fee or got a bill for a COVID-19 vaccine, Medicare.gov suggests these steps:

• Check the receipts and statements you get from your provider for any mistakes.
• Call your provider's office to ask about any charges you think are incorrect.
• If you have Original Medicare, review your Medicare Summary Notice for errors and report anything suspicious to Medicare at 1-800-MEDICARE (1-800-633-4227).
• If you have other coverage, like a Medicare Advantage Plan, review your Explanation of Benefits and report anything suspicious to your insurer.
• If you think your provider charged you incorrectly, ask for a refund. If you were charged for an office visit or other fee when the only service you got was a COVID-19 vaccine, report the provider to the Office of the Inspector General, U.S. Department of Health and Human Services, at 1-800-HHS-TIPS or oig.hhs.gov/fraud/report-fraud.

Can I get the COVID-19 vaccine at home?

Yes, in some cases. If you have Medicare and have a disability or face other challenges in getting to a location away from home for a vaccination, Medicare will pay a doctor or other care provider to give you the COVID-19 vaccine in your home, and there's still no cost to you for the vaccine and its administration.

Ask your regular doctor or health care provider whether they can give you the vaccine at home; if they can't, they might be able to refer you to someone who can. You can also call 1-800-MEDICARE for vaccine contacts in your state. Don't give out your Medicare Number or accept a vaccine from anyone who isn't a known or trusted provider, or who contacts you without your invitation. See what Medicare never does.

Does Medicare Advantage change COVID-19 vaccine coverage?

A Medicare Advantage Plan must give you at least the same coverage as Original Medicare, but the plan may have different rules. If you have a Medicare Advantage Plan, review your Explanation of Benefits for vaccine charges and report anything suspicious to your plan. See how Medicare Advantage differs from Original Medicare.