Key points
Information about paying for vaccines with private insurance, Medicare, and Medicaid. Options for military personnel and people without health insurance are also covered.
Private Insurance
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. The following vaccines are usually covered by health insurance:
- COVID-19
- Haemophilus influenzae type b
- Hepatitis A
- Hepatitis B
- Herpes zoster
- Human papillomavirus (HPV)
- Influenza
- Measles, mumps, rubella
- Meningococcal
- Pneumococcal
- Respiratory syncytial virus (RSV)
- Tetanus, diphtheria, pertussis
- Varicella
Check with your insurance provider for coverage details. Under the Affordable Care Act, insurance plans that cover children allow parents to add or keep adult children on their health insurance policy until they turn 26 years old.
Medicare
Medicare Part B plan will pay for the following:
- COVID-19 vaccines
- Hepatitis B vaccines for people at increased risk of hepatitis
- Influenza (flu) vaccines
- Pneumococcal vaccines
- 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 CDC (except those covered by Part B) available at no cost, including:
- Respiratory syncytial virus (RSV) vaccine
- Herpes zoster (shingles) vaccine
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.
Medicaid
Most adults with coverage from Medicaid are guaranteed coverage of all vaccines recommended by the CDC immunization schedule at no cost to them.
Military
If you serve in the military or are a military dependent, you are eligible for TRICARE. Under TRICARE, vaccines are covered according to the CDC recommended schedule.
No Insurance?
Adults
If you do not currently have health insurance, visit www.HealthCare.gov to learn more about affordable health coverage options.
You may also reach out to federally funded health centers, which provide preventive services, including vaccines. Many centers offer sliding fees based on income. Health departments may have additional information on where to go for free and low-cost vaccines. They may recommend going to local community centers, schools, or religious centers.
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