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Does Medicare cover flu shots?

Just the Essentials...

  • Seniors are at higher risk for developing complications from the flu than other age groups.

  • Original Medicare will cover the cost of one flu shot per individual beneficiary per flu season.

  • Medicare Advantage plans offer the same flu shot coverage that Original Medicare provides, and often include additional benefits.

Does Medicare cover flu shots?

The flu shot is an essential medical vaccine that seniors are encouraged to get every year. Many seniors may wonder, will Medicare pay for my flu shot?

Medicare does indeed cover flu vaccines. This article explains how Medicare Part B and Medicare Part C, or Medicare Advantage, cover senior flu shots.

Have questions about your Medicare coverage? Reach out to our team at (800) 950-0608 to explore your options, or browse plans online using our free quoting tool.

Flu shots are important for seniors.

If they contract the flu, seniors are at higher risk for complications than other demographics. For elderly individuals, catching the flu can lead to severe illness. The CDC estimates that between 50 and 70% of hospitalizations related to the flu occur in people over the age of 65. Furthermore, 70% to 85% of deaths from flu-related causes occur in the same age group.

Receiving a flu shot reduces the chance of getting sick, and even if seniors do get sick with the flu after vaccination, their course of illness will be milder.

Does Medicare pay for flu shots?

Flu shots are covered by Medicare Part B.

Medicare flu shot coverage includes eligibility to receive the vaccine every flu season. If a senior opts to get their flu shot late in one season and early in the next, Medicare may still pay for both shots even in the same year.

Seniors who have a Medicare Advantage plan are also covered for flu shots. Medicare Advantage plans must offer at least the same flu shot coverage as Medicare Part B.

Flu shots are covered with no copayment, coinsurance, or deductibles. However, in order for coverage to apply the beneficiary must meet all eligibility requirements for this service and see an in-network provider. Flu shots are typically distributed by many providers, including primary care physicians and pharmacies, and it is up to the beneficiary to make sure the location they choose is considered within network.

What is Medicare Advantage? If you’d like to speak with a licensed agent to explore your Medicare coverage options, call our hotline at (800) 950-0608.

What is the difference between Original Medicare and Medicare Advantage?

Original Medicare and Medicare Advantage cover essential services like flu vaccines. Both options have their similarities and their differences.

Original Medicare covers approximately 80% of services billed to it. The remaining 20% is up to seniors to cover under Part B after meeting their deductible. With Original Medicare, seniors are encouraged to purchase Medigap or supplemental insurance to help cover the cost. 

Medicare Advantage plans function like a traditional insurance plan. Like Medigap plans, they also help to cover the cost of services billed to the plan, but instead of a supplement, they are a replacement for Medicare Parts A and B, offering the same coverage as Parts A and B, and generally featuring additional benefits above and beyond that. Medicare Advantage plans may require enrollees to pay co-payments, a monthly premium, or a deductible for different services. A common reason for choosing Medicare Advantage over Original Medicare is that out of pocket costs tend to be lower.

The exact benefits and types of payments that enrollees make vary by plan. Plan types to choose from include:

  • Health Maintenance Organization (HMO). 
  • Preferred Provider Organization (PPO). 
  • Private Fee-for-Service (PFFS). 
  • Special Needs Plans (SNPs). 
  • Medical Savings Account (MSA). 

Like Original Medicare, Medicare Advantage plans are required to have the same basic coverage. Along with that coverage, Medicare Advantage benefits often include:

  • Dental
  • Vision
  • Hearing
  • Fitness memberships
  • Prescription drug coverage

How do I enroll in a Medicare Advantage plan?

Finding the right coverage with Original Medicare or Medicare Advantage can be a challenge. Seniors fear that they may be stuck with coverage that doesn’t fit them. Medicare addresses this by offering an open enrollment period each year from October 15 through December 7. This window allows seniors and other eligible parties to enroll in Medicare Advantage or Original Medicare. From January 1 through March 31, the Medicare Advantage Open Enrollment allows seniors to join a different Medicare Advantage plan or return to Original Medicare.

To learn more about Medicare Advantage coverage and Original Medicare, call us at (800) 950-0608. Our team of Medicare experts can help you find the plan that will fit your needs.

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