What to Know About Medicare COVID-19 Vaccine Coverage

When the World Health Organization declared COVID-19 a pandemic in March 2020, it was hard to imagine that we would have access to FDA-approved vaccines nine months later.

Understanding how Medicare COVID-19 vaccine coverage works and how much it costs is important so you can protect yourself.

Medicare Population and COVID-19 Risk

To be eligible for Medicare, you must be 65 years or older or you must have a qualifying disability. This population is at higher risk for more severe or complicated COVID-19 infections.

Age

Age, in and of itself, is a risk factor for severe COVID infections. As of December 2022, people aged 65 and older are the largest age group hospitalized for COVID-19.

Chronic Conditions

The National Institute on Aging reports that roughly 95% of adults age 60 and older have at least one chronic condition, and nearly 80% have two or more.

Research shows that certain chronic conditions, namely chronic kidney disease, chronic obstructive pulmonary disease (COPD), diabetes, heart disease, and obesity, increase the risk for serious infection or complications from COVID-19.

Long Term Care Facilities

According to a 2019 National Center for Health Statistics study, more than 1.3 million people reside in nursing homes. More than 83% were aged 65 and older.

Cost of COVID Vaccines

If you're 65 and older or at high risk, Medicare will cover the COVID-19 vaccine and booster shots at no cost to you. You don't have to pay a deductible, copayment, or coinsurance. If the vaccine is the only medical service you get, your healthcare provider can't charge you for the office visit.

If you think your healthcare provider incorrectly charged you for the COVID-19 vaccine, ask them for a refund. 

If you have a Medicare Advantage Plan, reach out to your health plan. You may need to file a claim with your insurance company. All fees should be removed.

Fighting Vaccine Hesitancy

Some people may be hesitant about getting the vaccine. They may be uncertain about the vaccine in general, but hopefully, the data above shows that they are safe and effective.

According to USAFacts.org, almost 73% of people 65 to 74 were fully vaccinated (83% had received at least one dose), and almost 71% of people 75 and older were fully vaccinated (more than 80% had received at least one dose) by June 10, 2021.

This appears to have saved lives. In December 2020, deaths from COVID-19 in nursing home residents were as high as 6,034 per week. By the end of May 2021, those deaths were down to 116 per week, even though many areas of the country continued to have rising infection rates in their communities at the time.

The Centers for Disease Control and Prevention (CDC) also reported that seniors vaccinated with one of the mRNA vaccines were 94% less likely to be hospitalized for COVID-19.

What you should not worry about is cost. A study by TZ Insurance Solutions found that more than 320,000 Medicare beneficiaries haven’t gotten vaccinated due to concerns over expense. Do not be misled. COVID-19 vaccination is free to you no matter what.

Summary

Medicare beneficiaries are statistically at higher risk for getting symptomatic COVID-19 infections. The vaccines currently approved for use in the United States are effective, safe, and free to you.

Protect yourself. Wear masks when you are out in public, avoid crowds, and maintain social distancing. If you haven’t already been vaccinated, you can use the vaccine finder tool courtesy of the CDC.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.