Medicare coverage of flu shots

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Last Update: August 22, 2011

Medicare Part B covers 100 percent of the cost of a flu shot once every flu season with no Part B deductible required. This is true for both Original Medicare and Medicare Advantage plans (private health plans).

For a list of doctors who take assignment, go to the LINKS box.

Original Medicare will pay for the flu shot no matter where you get it, as long as the health care provider is enrolled in Medicare. You will pay no copay or deductible if you see a doctor or other health care provider who takes assignment. Providers who take assignment cannot charge you more than the Medicare approved amount. If you receive your Medicare benefits from a private plan, the plan cannot require that you get a referral for the vaccine, but it can require that you use providers in the plan’s network. You should call your plan to find out what rules apply. 

To find out Medicare's reimbursement rate for flu shots in your area, click on the link in the LINKS box.

The flu season usually runs from November through April. Therefore, Medicare may cover a flu shot twice in one calendar year. For example, if you get a shot in January 2011 for the 2010/2011 flu season, you could get another shot in October 2011 for the 2011/2012 flu season.


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LINKS
Medicare.gov -- Search for Participating Physicians

Flu Shot Reimbursement Amounts by Area in the U.S.

National Directory of Medicare Regional Carriers and Intermediaries

Medicare.gov: National A/B MAC Information

 
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