Part D coverage of Shingrix

[GlennL90251]

1. The Shingrix web site claims that most Part D plans cover Shingrix with a co-pay of $50 or less, assuming you have already met your deductible for the year.

2. The AARP web site also claims that most Part D plans cover Shingrix with a modest co-pay.

3. My wife got a Shingrix vaccine yesterday. Her Plan D cost was higher than the GoodRX price of about $180.

4. On the Medicare Plan Finder web page, I added Shingrix to my list of drugs. The results showed that the cheapest price from a Part D plan was about $500.

Can anyone explain this inconsistency? If Part D plans don't cover Shingrix, then why do the Shingrix and AARP web sites claim that they do?

Glenn

[GailL1]

2022 Part D plans should cover Shingrix but the amount of out of pocket is gonna vary by the plan and whether or not the deductible has been satisfied for 2022.

BTW, it is (2) shot dose, taken a few weeks apart - I forgot how long. The price could cover both shots - depends on the plan.

You (and wife) are gonna probably kick yourself when I tell you that beginning January 2023, the Inflation Reduction Act legislated that for those vaccines that are recommended by the ACIP/CDC, there are NO copays applicable -

Medicare.gov - Saving money with the Inflation Reduction Act

From the link ~

Better access to vaccines

Starting in 2023, people with Medicare Part D drug coverage will pay nothing out-of-pocket for even more vaccines, including the shingles vaccine, that are recommended by the Advisory Committee on Immunization Practices.

Sorry, I don't think she can give it back - 😜

[GlennL90251]

Thanks. This echoes what AARP says, but it does not agree with my experience. I guess it is moot since 2023 is right around the corner.