August is Immunization Awareness Month
As we get older, our immune systems tend to weaken, putting us at higher risk for certain diseases. The U.S. Centers for Disease Control & Prevention (CDC) advises all adults age 65 and older to make sure they’re up to date on these vaccines:
- COVID-19.
- Flu (influenza).
- Pneumococcal (pneumonia and meningitis).
- Zoster (shingles).
- Tdap (tetanus, diphtheria and pertussis/whooping cough) or Td (tetanus and diphtheria).
You may need other vaccines based on your age, health conditions, job and other factors. Talk with your doctor to learn which vaccines are recommended for you. These may include respiratory syncytial virus (RSV).
How to pay for vaccines
All health insurance marketplace plans and most other private insurance plans must cover certain vaccines without charging a copayment or coinsurance when provided by an in-network provider. This is true even for patients who have not met a yearly deductible. Doses, recommended ages and recommended populations for vaccinations vary.
Private health plans are required to cover new vaccine recommendations in the next plan year. However, some insurance plans may cover them in the current plan year. Check with your insurance provider for details on whether there is any cost to you for recommended vaccines.
Medicare Part B will pay for these vaccines: COVID-19; hepatitis B (for people at increased risk); flu; pneumococcal; and vaccines directly related to the treatment of an injury or direct exposure to a disease or condition, such as rabies and tetanus.
Medicare Part D plans make all adult vaccines recommended by the CDC Advisory Committee on Immunization Practice (except those covered by Part B) available at no cost, including RSV and shingles. Even if a particular drug plan’s formulary doesn’t list all Part D vaccines, it must provide access when a physician prescribes a Part D vaccine. Contact your health insurance provider to find out about your coverage.
Most adults with coverage from Medicaid will be guaranteed coverage of all vaccines recommended by the Advisory Committee on Immunization Practice at no cost to them.
If you do not currently have health insurance, call 1-844-844-4440 or visit pennie.com to learn more about affordable health coverage options for Pennsylvania residents. If you are eligible for Medicare, you can receive free health insurance advice from PA MEDI (Pennsylvania Medicare Education and Decision Insight Program) by calling Einstein Medical Center at 215-456-7600 or Center for Advocacy for the Rights and Interests of Elders (CARIE) at 215-545- 5728. For more information about PA MEDI, go to www.pcaCares.org/pamedi.
(Source: U.S. Centers for Disease Control & Prevention)
