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

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Honored Social Butterfly

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

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 !  😉 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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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.

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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

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Honored Social Butterfly

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 !  😉

 

 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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