In Need of Some Medicare Part D Covered Vaccines ?- Shingrix, Tdap, various Pneumonia vaccines, etc.

[GailL1]

As part of the IRA (Inflation Reduction Act) just signed into law today - these Part D vaccines recommended for the Medicare group will be changed to NO OUT OF POCKET COST beginning in 2023.

Avalere 08/16/2022 - The IRA will expand adult vaccine access by mandating coverage without cost sha...

from the link ~

• Eliminating Vaccine Cost Sharing in Medicare Part 😧 Starting January 1, 2023, all Medicare Part D plans will be required to cover all ACIP-recommended adult vaccines with no cost sharing, even if the beneficiary is in the deductible phase of the benefit. As a result, 9 million Part D-enrolled beneficiaries will now have access to ACIP-recommended Part D vaccines without cost sharing.

No more cost excuses - now, roll up your sleeve !  😉 

[MVH1153]

I'm not sure what "ACIP-recommended" entails. Would a vaccine for Shingles fall into this category?

It seems that my provider won't provide this, and my insurer told me that the first shot would cost me about $185 out-of-pocket.

[RMK]

Thanks a TON, Gail@  This is really, really helpful, and I am so glad i FOUND some info on this.  There is a severe communication gap out there among providers, pharmacies, insurers, and workers about the fact that shingles will be covered next year.  Only way I found out was through your post!   Appreciate this so much.  Chris

[GailL1]

ACIP is the CDC's Advisory Committee on Immunization Practices (ACIP)

They are the ones that recommend which vaccines are approved and when they are recommended.

BY SPECIFIC AGE GROUP:

https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html#table-age 

Here is a printable 2022 list by age group:

https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule-bw.pdf 

The new shingles vaccine is on the list - Zoster recombinant (RZV) - brand name is Shingrix - (2) doses with some time in between them.  So completely covered beginning in 2023 - with NO out of pocket cost if you are on Medicare with a Part D plan.  But in most all instances, you have to get it at a participating pharmacy because your doctors cannot bill your Part D insurer.  A participating pharmacy is just the one that participates in your plan and has a pharmacist or more than one that your state has authorized to give these vaccines - just like the flu vaccine that you get every year.

So come 2023 - no more cost excuses - now roll up that sleeve !  😉