Health NewsMedicare NewsDoes Medicare Cover the Flu Shot?

Does Medicare Cover the Flu Shot?

Influenza, commonly known as the flu, is a virus that causes coughing, fever, sore throat, fatigue, and headaches. Death can become part of the equation if you are an elder, primarily because of the weaker immune system. This is why flu shots are essential, as they protect and help prevent the spread and contracting of the possibly fatal virus.

The flu can lead to other illnesses such as bronchitis and pneumonia, which are extremely dangerous if left too long. Thankfully there is a simple way to prevent the flu virus from turning into a fatal disease. If eligible, medical programs, such as Medicare even offer this potentially life-saving shot for free.

What is Medicare?

It began in 1965 in the United States by the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services.
Medicare is a health insurance program tailored to people at the age of 65 and older,  younger individuals with disabilities, and those with end-stage renal disease such as ESRD (permanent kidney failure that requires a transplant or dialysis).

Medicare offers four parts ranging in what the customer needs. These are labeled Part A, B, C, and D.
This health insurance company program is funded through the Hospital Insurance Trust Fund and the Supplementary Medical Insurance Trust Fund. It aims to provide medical procedures and care coverage, focusing mainly on the elderly. What will be covered depends solely on which part of the program is chosen.  

Will Medicare Cover My Flu Shot?

Does Medicare Cover the Flu Shot - doctor at the office | Healthier Me Today

Many places accept Medicare Advantage Plans. Elderly people who have Medicare Part B, C, or D can receive their yearly flu shot for free.

If you meet the criteria of Medicare and depending on which plan you choose or are recommended, then yes, Medicare will cover your flu shot. Those covered are citizens 65 and over, the disabled, those with end-stage renal diseases amyotrophic lateral sclerosis. 

How Can I Get Medicare Flu Shot Coverage?

To get Medicare flu shot coverage, you will need to see if you qualify for the B and C program plans. If you do, these parts will cover the entire cost of the flu shot. From here, you will need to phone your healthcare provider ahead of time to ensure that they accept Medicare coverage and payments. If they do, simply go to your pharmacy or healthcare provider, and they will provide you with your flu shot. 

Medicare Part A-D

The Medicare program offers four options for whatever type of services are needed. Most beneficiaries opt for Parts A and B benefits through Original Medicare, which is provided directly through the federal government, the traditional fee-to-services program.

Using Traditional or Original Medicare will result in the government paying for the medical services you receive. With this, you are responsible for paying for a monthly premium for plan B, and some choose to do this as well for plan A.

If you choose to use the Medicare Advantage plan instead, this will offer the same benefits as Original Medicare but can do so with different rules, costs, and coverage restrictions, as well as typically receiving Part D, which covers prescription medication.
There are many different kinds of Medicare Advantage Plans, also known as Part C. Here is a list explaining what each of the various Parts covers.

Medicare A Coverage:

  • Hospital stays
  • Skilled nursing facilities 
  • Home health care
  • Hospitalizations
  • Hospice 
  • It does not include flu shot

Medicare B Coverage:

  • Quadrivalent cell-based influenza, including Flucelvax Quadrivalent
  • Standard dose quadrivalent shots Afluria Quadrivalent, Fluarix Quadrivalent, 

FluLaval Quadrivalent, and Fluzone Quadrivalent  

  • Recombinant quadrivalent influenza shot including Flublok Quadrivalent   
  • Covid-19 vaccines 
  • Seasonal H1N1 swine flu vaccines 
  • Pneumococcal vaccine
  • Hepatitis B shots for individuals at high-risk 
  • Fluzone High-Dose for those older than 65 years of age 
  • FLUAD
  • Certain shots are related to illness or injury. Example tetanus shots 
  • Helps cover durable medical equipment (wheelchairs, walkers, hospital bed, as well as other equipment)
  • Outpatient care

Medicare C Coverage:

  • Quadrivalent cell-based influenza, including Flucelvax Quadrivalent
  • Standard dose quadrivalent shots Afluria Quadrivalent, Fluarix Quadrivalent, 

FluLaval Quadrivalent, and Fluzone Quadrivalent  

  • Recombinant quadrivalent influenza shot including Flublok Quadrivalent   
  • Covid-19 vaccines 
  • Seasonal H1N1 swine flu vaccines 
  • Pneumococcal vaccine
  • Hepatitis B shots for individuals at high-risk 
  • Fluzone High-Dose for those older than 65 years of age 
  • FLUAD
  • Certain shots are related to illness or injury. Example tetanus shots 
  • Hospital stays
  • Skilled nursing facilities 
  • Home health care
  • Hospitalizations
  • Hospice 
  • Does not include flu shot
  • Specific Part C plans include prescription drug coverage

Medicare D Coverage:

  • Shingles Vaccine, Shingrix
  • Tdap vaccine for tetanus, diphtheria, and pertussis (whooping cough)
  • MMR vaccine (measles, mumps, and rubella)
  • BCG vaccine for tuberculosis 
  • Meningococcal vaccines
  • Hepatitis A and B vaccines for individuals considered high-risk 
  • Generic Tamiflu
  • Relenza 
  • Xofluza
  • Flu medication

Will I be covered if I am a Senior?

Does Medicare Cover the Flu Shot - Elder reading | Healthier Me Today

Senior citizens who are 65 and older will receive the flu shot for free once a year. If deemed medically necessary, it will be given again in the same year, also free of charge. This will only be possible if the patient has Medicare Parts B, C, or D, as Part A does not include the influenza vaccine. If the senior citizen does not have any of these Medicare plans, they will be charged for the shot. The Fluzone High-Dosage is recommended for anyone over 65, as they are at greater risk when contracting the virus.

All about the Flu Shot

Medicare can be an easy option for seniors. It takes the stress out of wondering how, where, and when they will be able to get in contact with healthcare providers. Additionally, it takes the uncertainty of finances away! 

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