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The $0 list

Vaccines on Medicare: the answer is $0, finally including shingles

Short answer: every vaccine an adult on Medicare is recommended to get now costs $0. Flu, COVID-19, pneumococcal, and hepatitis B shots run through Part B at no cost, and since 2023, every other ACIP-recommended vaccine, including the shingles vaccine that used to cost people $200 a dose, plus Tdap and RSV, is free under Part D. The one surviving trap is administrative: getting a Part D vaccine at a place that can’t bill your drug plan. Here’s the full list and the one question that avoids the trap.

By the Medicare Decoder team · Updated August 10, 2026 · 4-minute read · Figures are official 2026 amounts

Key takeaways

  • Part B vaccines at $0: flu (annual), COVID-19, pneumococcal, hepatitis B for at-risk groups, plus post-exposure shots like tetanus after injury.
  • Part D vaccines at $0 since 2023: shingles (Shingrix), Tdap, RSV, and every other ACIP-recommended adult vaccine.
  • The $0 applies with no deductible: vaccines bypass your drug plan’s deductible entirely.
  • The trap: Part D vaccines bill through your drug plan, so pharmacies handle them cleanly; some doctor’s offices can’t, and you front the cost.
  • One sentence prevents it: "Can you bill my Part D plan directly for this vaccine?" If not, use a network pharmacy.
Jump to The Part B list The Part D list The billing trap Building your schedule FAQ

The Part B list: the medical-side vaccines

Four categories bill through Part B at $0, any Medicare-enrolled provider, no deductible: the annual flu shot (including high-dose formulations for 65+), COVID-19 vaccines and boosters, pneumococcal vaccines (the pneumonia series; current guidance for 65+ typically involves one or two products, which your pharmacist will sequence), and hepatitis B for people at increased risk (diabetes qualifies). Part B also covers vaccines as treatment after exposure, a tetanus shot following the garden mishap, under normal medical billing. These have been free for years and rarely cause trouble.

The Part D list: where the news is

Everything else recommended for adults lives in Part D, and since 2023 federal law requires plans to cover ACIP-recommended vaccines at $0, with no deductible. The headline is Shingrix, the two-dose shingles vaccine recommended for 50+, which previously cost Medicare patients real money and drove years of angry forum threads: now free, both doses. Also on the list: Tdap (tetanus-diphtheria-pertussis boosters on schedule), RSV vaccines for older adults per current guidance, and hepatitis A and B outside the Part B risk groups. If ACIP recommends it for you, your drug plan covers it at zero.

The one surviving trap, and its one-sentence fix

Part D vaccines bill through your drug plan, which pharmacies do natively: walk into a network pharmacy with your Part D card, walk out vaccinated, pay nothing. A doctor’s office, though, bills medical insurance, and many can’t bill a drug plan at all, so the office may charge you up front and leave you chasing reimbursement paperwork with your plan. The fix is asking before the needle: "Can you bill my Part D plan directly for this vaccine?" If the answer wobbles, the pharmacy next door does this a hundred times a week. (Flu, COVID, and pneumonia shots don’t have this problem; they’re Part B and bill anywhere.)

Building your schedule

The clean way to assemble your personal list is the Annual Wellness Visit, where vaccine history review is a named component and the prevention plan you leave with should map every due dose: flu each fall, COVID per current guidance, the pneumococcal sequence once, Shingrix’s two doses two to six months apart, Tdap every ten years, RSV per age and risk. Pharmacies also run vaccine reviews on request and can usually see your fill history. Two habits close the loop: get doses recorded in your state registry (ask; it’s routine), and when a household caregiver or younger spouse is getting theirs, remember their coverage runs on different rules until their own Medicare begins. The era of the $200 shingles shot is over; the only cost left is remembering to go.

Questions people also ask

Is the shingles vaccine free with Medicare?
Yes. Since 2023, Shingrix is covered at $0 under Part D, both doses, with no deductible, at any network pharmacy. The old $150–$200-per-dose experience is gone; if you’re quoted a price, the billing route is wrong, not the benefit.
Which vaccines does Medicare cover for free?
All of them that are recommended for adults: flu, COVID-19, pneumococcal, and at-risk hepatitis B under Part B, and every ACIP-recommended vaccine, including shingles, Tdap, and RSV, at $0 under Part D. Post-exposure vaccines like tetanus after an injury are covered as medical treatment.
Why was I charged for a vaccine at my doctor’s office?
Part D vaccines bill through your drug plan, which many medical offices can’t do; they charge you and leave you to seek reimbursement. Ask “can you bill my Part D plan directly?” first, or get Part D vaccines at a network pharmacy, where $0 happens automatically.
Does Medicare cover the RSV vaccine?
Yes, at $0 under Part D for adults per current ACIP recommendations. Like other Part D vaccines, the smooth path is a network pharmacy with your drug plan card.
Do vaccines count toward my Part D deductible?
No; covered vaccines bypass the deductible entirely and cost $0 even if you haven’t spent a dollar yet. They also don’t consume any of your $2,100 out-of-pocket cap, since you pay nothing.

Sources for this article

Figures checked against these sources in August 2026. We update within weeks when CMS publishes new amounts.

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