The risk of getting shingles increases as you age. In fact, around half of all shingles cases are in people aged 60 and higher.
What is shingles?
Shingles is a viral infection that causes a rash or blisters on the skin. The rash usually forms after initially experiencing burning pain, tingling or itching. Shingle is caused by the same virus that causes chickenpox. For anyone that has ever had chickenpox, there is good chance the virus is still in your body.
How do you prevent shingles?
Vaccination is the only proven method to prevent shingles. The Centers for Disease Control and Prevention (CDC) recommends that healthy adults get the shingles vaccine – called Shingrix. The CDC recommends two doses of the vaccine, separated by 2 to 6 months.
Medicare Part D covers the Shingles vaccine
All Part D prescription drug plans are required to cover the shingles vaccine. In addition, Medicare Advantage plans that include drug coverage also cover the shingles vaccine.
Part A and Part B do not cover the shingles vaccine. Consequently, your Medicare Supplement (Medigap) plan won’t cover the shingles vaccine.
In summary, you will need a Part D drug plan to get your shingles vaccine covered. This Part D drug plan can be a stand alone plan paired with a Medigap plan or it can be wrapped inside of a Medicare Advantage plan.
Your Part D cost for a shingles vaccine
Your shingles vaccination cost will depend on the following variables:
- whether or not your Part D drug plan has a deductible
- which Part D stage you are in (Deductible, Initial Coverage Phase, Coverage Gap or Catastrophic coverage)
- which Tier your plan lists the shingles vaccine (most plans list the vaccine in Tier 3)
- whether you receive the vaccine from one of your plan’s “preferred providers”
How effective is the shingles vaccine?
Shingrix is 97% effective in preventing shingles in 50 to 69 year old people who took two doses. Additionally, protection stays above 85% for four years after you receive the vaccine.
If you are unsure about how your Part D drug plan or Medicare Advantage plan will cover your shingles vaccine, you can receive free guidance by calling or texting us at 913-717-6782. You can also email us at scott@ksmedigap.com.