Medicare will cover 100% of the cost of two separate, different doses of the pneumonia vaccine with no Part B deductible required if you are in Original Medicare or a Medicare Advantage Plan. Medicare Advantage Plans cannot require that you get a referral for the vaccine, but can require that you use network providers. You should call your plan to find out what rules apply. If you are in Original Medicare you will have no copay or deductible if you see providers who take assignment.
Currently, there are two types of pneumonia vaccines available. As of September 19, 2014, Medicare Part B will cover an initial pneumonia vaccine if you have never received the pneumonia vaccine under Medicare Part B before. Medicare will also cover a second, different type of pneumonia vaccine at least one year after the first vaccine was administered.
You are not required to provide a vaccination history when receiving the pneumonia vaccine. You can verbally tell the health care professional administering the shot if and when you have received any pneumonia vaccines.
Speak with your doctor to learn more about the types of pneumonia vaccines and to discuss receiving these vaccines.