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Part C Coverage Confusion

I have a Medicare Advantage plan but I'm confused about some things associated with these plans. As I understand it, Part C is supposed to cover everything that Part A and Part B covers.


However, when I go to get certain vaccinations from my pharmacy like the Flu shot or Pneumonia shot, they insist on using my Medicare card and do not want the Advantage card.


So I don't get it. If they want my Medicare card, that means Medicare covers it, so my Advantage plan should cover it too, right?

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Honored Social Butterfly

 Medicare Part B pays for one flu shot in each flu season, which typically runs from November through April, regardless of whether you’re enrolled in the original Medicare program or in a Medicare Advantage plan.


If you’re in original Medicare, the shot is free (no deductible, no copay) if you have it administered by a doctor or pharmacist who accepts Medicare assignment — that is, has agreed to accept the Medicare-approved payment as full reimbursement for providing this service.


If you’re in a Medicare Advantage plan (such as an HMO or PPO), the shot is still free. But you may be required to have it administered by a doctor who is in the plan’s provider network.


So your problem can be solved by going to one of your in-network medical providers - preferably, your primary care physician.  

Pharmacist aren't normally in a medical provider network which MA plans have.

It's Always Something . . . . Roseanna Roseannadanna
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