does cvs accept medicare assignment for flu shots

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Does Medicare Cover Flu Shots?

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Medicare Part B (Medical Insurance) covers one flu shot each flu season and will cover additional flu shots if they’re deemed medically necessary .

Because flu season usually lasts from fall to spring, this could mean that you get two flu shots in one year — but in different flu seasons — and both shots are covered.

Shopping for Medicare plans? We have you covered.

There are no costs for a flu shot under Original Medicare , as long as the health care provider accepts Medicare assignment for the shot. That means there's no deductible and no coinsurance.

Medicare Advantage plans must provide at least as much coverage as Medicare Part A and Medicare Part B , so they also cover one flu shot per season at no cost. But you may have to see a doctor in the plan’s network to be covered.

» MORE: Does Medicare cover COVID-19 testing and vaccines?

The parts of Medicare

Read more about the different parts of Medicare and what they cover.

Medicare Part A (hospital insurance).

Medicare Part B (medical insurance).

Medicare Part C (Medicare Advantage).

Medicare Part D (prescription drug plan).

Medicare Supplement Insurance (Medigap).

Should you get a flu shot?

Vaccination for the flu is recommended if you’re at higher risk of developing serious health complications from the flu. This group includes:

People 65 and older.

People with chronic health conditions, such as asthma, heart disease, diabetes and chronic kidney disease.

Pregnant women.

People with HIV/AIDS.

People with cancer.

What are flu shot side effects?

Side effects from the flu shot are typically mild, but they may include headache, fever, nausea, fatigue, muscle aches and redness, soreness and/or swelling at the injection site.

What Medicare covers

Medicare covers a lot of things — but not everything. Find out where Medicare stands in the following areas:

Dental care.

Hearing aids.

Shingles vaccine.

Cataract surgery.

Chiropractic care.

COVID testing and vaccines.

Home health care.

Acupuncture.

Nursing home care.

Assisted living.

Dental implants.

Mental health services.

Addiction treatment.

Ambulance services.

On a similar note...

Still deciding on the right carrier? Compare Medigap plans

Does Medicare Cover Flu Shots?

• by Christian Worstell
• January 12, 2024
• Reviewed by John Krahnert

Medicare Part B covers one flu shot per flu season , which typically runs from October to May each year. If your doctor accepts Medicare assignment, Medicare Part B covers the flu shot in full.

Medicare Advantage (Medicare Part C) plans also cover flu shots . Medicare Advantage plans may also offer other benefits that Original Medicare (Part A and Part B) don’t cover. 

What do Medicare Advantage plans pay for flu shots?

Medicare Advantage plans cover 100 percent of the Medicare-approved amount for an annual flu shot during the fall or winter months.

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This means that you will typically not have to pay a coinsurance or copayment for your flu shot, as long as you visit a doctor who accepts Medicare and the terms of your Medicare Advantage plan.

In addition to the standard hospital and medical benefits of Medicare Part A and Part B, Medicare Advantage plans may also include coverage for other benefits not found in Original Medicare. 

Check with your health care provider if you have questions about a specific immunization or vaccine that is not listed here.

Does Medicare cover other vaccines?

Flu shots aren’t the only vaccines covered by Medicare.

Medicare Part B and Medicare Advantage plans also cover preventive vaccines such as pneumonia shots (pneumococcal vaccine) and Hepatitis B shots. Medicare Part B and Medicare Advantage plans may also cover vaccines such as rabies shots if they are considered medically necessary by a doctor.

Specific costs, including monthly premiums, deductibles and coinsurance will vary depending on the Medicare Advantage plan you enroll in.

A licensed insurance agent can help you compare Medicare Advantage plans in your area and get you enrolled in a plan that works for you.

Find Medicare Advantage plans in your area

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at [email protected] .

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What vaccines does Medicare cover?

Kimberly Lankford,

Medicare Part B  covers many vaccines as  free preventive benefits , meaning you won’t have to pay deductibles or copayments.  Medicare Part D , the prescription drug coverage you can purchase from private companies that Medicare regulates, also covers some common vaccines.

Thanks to the 2022 Inflation Reduction Act , you no longer have to pay copayments or deductibles for recommended vaccines that either part of Medicare covers. The law eliminated cost sharing on many types of screenings, vaccines and prevention programs the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends for adults.

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Which vaccines does Medicare Part B cover?

Here’s a list of vaccines Part B covers. You may need to meet certain criteria based on age, risk and the time frame in which you receive the vaccine or a series of vaccines. 

COVID-19.  Medicare continues to cover  COVID-19 vaccines , even though the  public health emergency  ended May 11, 2023. Providers who participate in Medicare can’t charge beneficiaries for the vaccine.  

Flu.  Considered an annual vaccination, most people of all ages receive  flu shots  around flu season, which typically runs October through May with peak activity from December to February. The CDC recommends that adults 65 and older get the  high-dose version  for extra protection. 

Hepatitis B.  This is covered as a preventive benefit if people are at  medium or high risk  for the virus, including those with diabetes, end-stage renal disease or hemophilia.  

Pneumonia.  This vaccine helps protect you against  pneumococcal disease , which can cause pneumonia, meningitis and other infections. Medicare covers either the single-dose vaccine or a two-dose series with the second dose required at least one year later for most people 65 and older. People who are immunocompromised could receive the second dose sooner.  

You can use your  online Medicare account  to help keep track of the Medicare-covered screenings and vaccines you’re eligible for in Part B.  

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What vaccines does Medicare Part D cover?

Unless Part B covers a vaccine, Part D plan  formularies  usually cover all commercially available inoculations to prevent illness. These include:

Hepatitis A.  The CDC recommends a hepatitis A shot for children age 12 to 23 months and children age 2 to 18 who weren’t vaccinated earlier. It also recommends the vaccine for adults at  increased risk for hepatitis A , including people with chronic liver disease or those who have HIV or work in areas with a risk of infection as well as others at high risk. 

Hepatitis B.  For those at low risk for hepatitis B.  

RSV.   Respiratory syncytial virus  can lead to pneumonia or bronchiolitis and can worsen other chronic conditions common among older adults, such as asthma and chronic obstructive pulmonary disease (COPD). In 2023, the  Food and Drug Administration approved  the RSV vaccine for adults 60 and older to help protect against contracting the virus.  

Shingles.  The CDC recommends that  everyone 50 or older  get the  shingles vaccine . It recommends two doses of Shingrix spaced two to six months apart, even if you previously received Zostavax. In 2020, Shingrix replaced Zostavax, which is no longer available in the U.S.

Tdap.  This shot protects against tetanus, diphtheria and whooping cough, also known as pertussis. The CDC recommends getting a  Tdap or Td booster  every 10 years. 

Even some less-common shots.  These include immunizations you may need for travel to Africa, Asia, Central and South America, and the Pacific Islands, which are usually covered through Part D without deductibles or copayments if the CDC recommends them for your travel.

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How does the change in law affect me?

Before the  Inflation Reduction Act  eliminated all out-of-pocket costs for vaccines beginning in 2023, chances are you were probably charged a copayment for vaccines billed to your Part D insurer instead of Part B.

In 2021, before the law changed, 3.4 million people received vaccines under Part D, paying $234 million in out-of-pocket costs. Broken down by vaccine, that averages to about:​

• $77 per patient for the shingles vaccine
• $28 for the Tdap vaccine
• $34 for the hepatitis A vaccine
• $51 for the hepatitis B vaccine

Before 2023, some people paid as much as $193 for the shingles vaccine and $66 for the Tdap vaccine, according to the Centers for Medicare & Medicaid Services.

In 2023, more than 42 percent more people received the shingles vaccine than in 2021, and 112 percent more people received the Tdap vaccine in 2023 than in 2021.

Keep in mind

Medicare Advantage plans  must cover the same Part B preventive services without any cost to you if you use an in-network provider. You may be charged if you use an out-of-network provider.

If your Medicare Advantage plan includes drug coverage, it must also cover the Part D vaccines the CDC recommends (listed above) without cost sharing.

Return to Medicare Q&A main page

Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at  Kiplinger’s Personal Finance  and has written for  The Washington Post  and  Boston Globe . She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.

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Get  payment allowances & effective dates  for the 2023–2024 season.

This content is for health care providers. If you're a person with Medicare, learn more about  flu shots . 

Consider giving a preferred vaccine to your patients 65 and older. P referred vaccines are potentially more effective than standard dose flu vaccines. There are 3 recommended vaccines:

• Fluzone High-Dose Quadrivalent vaccine
• Flublok Quadrivalent recombinant flu vaccine
• Fluad Quadrivalent adjuvanted flu vaccine

If one of these recommended vaccines isn’t available, give your patients a standard-dose flu vaccine instead.

Frequency & Coverage

• The CDC recommends annual flu shots for everyone 6 months and older each flu season. September and October are the best times for most people to get vaccinated.
• Medicare Part B covers the seasonal flu shot.
• We cover additional flu shots if medically necessary. Patients can get flu shots twice in a calendar year during 2 different flu seasons, and we’ll pay for both shots.
• Your patients pay nothing if you accept assignment. There’s no copayment, coinsurance, or deductible.
• CPT or HCPCS codes
• Dates of service
• NPIs who administered the shots

If you need help, contact your eligibility service provider.

• All providers who administer the flu shot must accept assignment.
• You may use roster billing or submit an individual claim. Learn more about  roster billing, mass immunizers, and centralized billing .
• Entities, like local health facilities, must get an  NPI (PDF)  if they’ve never submitted Medicare claims.
• Starting on January 1, 2024, you may bill for an additional payment for administering the flu vaccine to Medicare patients in their homes under certain circumstances. Learn more about the  In-Home Vaccine Administration: Additional Payment .
• Skilled nursing facility enforcement discretion for pharmacy billing  ended on June 30, 2023. You can bill for flu shot administration and vaccine products with dates of service from September 20, 2021 – June 30, 2023.

ICD-10, HCPCS, and CPT codes

ICD-10 Code: Z23

Additional Resources

• Flu Shot & Administration  
• Preventive Services webpage
• CDC Flu  webpage
• Office of Minority Health Immunization and Vaccine Resources webpage
• Annual Influenza Vaccination (PDF) data snapshot: Learn about disparities in Medicare patients
• Section 50.4.4.2  Medicare Benefit Policy Manual, Chapter 15 - Covered Medical and Other Health Services (PDF)
• Section 10  Medicare Claims Processing Manual, Chapter 18 - Preventive and Screening Services (PDF)

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Keep yourself and those close to you healthy! Join the millions of people who get their yearly flu shot.

No one likes getting sick. And the flu virus changes every year. So, getting a yearly shot helps protect yourself and those around you. Plus, it’s available at no cost to you .

The flu shot is a good idea for just about everyone.  

But these people are at an even higher risk of health problems from the flu:

Pregnant Moms  Pregnancy can put you at higher risk for getting the flu and put your unborn baby at risk, too. But getting a flu shot can help protect you and your baby.

Children and Families Young children have a higher risk of health problems from the flu. Newborns are also at a high risk but can’t get the flu shot until they are six months old.

People with a Chronic Condition or Caregivers People with a weakened immune system are more likely to get very ill from the flu. Getting your yearly flu shot helps protect yourself and those around you.

Seniors or Those Who Care for Them Our immune defenses weaken with age. And people age 65 and older are at a higher risk for health issues from the flu. If you’re a senior or live with seniors, a flu shot will help protect you all.

Common Questions About the Flu

• Flu viruses are always changing. Scientists predict which virus will be most common each year. Flu vaccines are changed each flu season to make them work as well as possible.
• Your protection with the flu shot gets weaker over time. That’s why a yearly flu shot is needed to keep you from getting sick.
• You should get a flu shot before the flu starts spreading where you live. Fall is the best time to get your yearly shot. If possible, get the shot by the end of October.
• You can get your flu shot in many doctor’s offices. You can also get it in pharmacies, clinics and health centers. Vaccines may also be offered at schools or your workplace.
• Check out the  SHARE  approach to learn how our Providers help patients with flu prevention.

The flu is different from a cold. The flu usually comes on suddenly. People who have the flu often feel some or all of these symptoms:

• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Fatigue or tiredness
• Some people may have vomiting and diarrhea. This is more common in children than adults.

Visit your doctor or urgent care or call the nurse advice line with any health questions. Unless you have a very high fever or trouble breathing, you should not need to go to the emergency room for the flu.

*Only members age 2 or older can receive the flu vaccine at a pharmacy.

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