Insurance agents and their Medicare clients tend to think that since the flu shot is free on Medicare, the shingles vaccine will be also. Spoiler alert: it isn’t. You’ll feel the pain of the shot more in your wallet, than in your arm.
Head off complaints from your clients by discussing this shot during your annual PDP review: If your clients asks for the shot in her doctor’s office, since it falls under Part D, she will have to pay for it and seek reimbursement from her Part D plan–and almost guaranteed be irritated at you, her insurance agent for this added work and frustration.
Flu and pneumonia shots are covered under Medicare Part B and are Free preventative care. This leads people to assume that other shots will be free too. In reality, Part D covers most vaccines.
The shingles shot is a Tier 3 or 4 co-pay with most PDP plans
(there is no generic available yet)
There is a national ad campaign to get people age 50 and older to get the new shot, which unlike the old shot, takes two doses for full protection. The old shot was only available for people age 60 and over, and the new shot starts at age 50. Let’s call the new shot by it’s name Zostavax.
It costs about $200 without insurance.
The best bet it to educate your clients about this shot. Over 1 million people get the shingles each year and it can linger for the rest of their life! It causes painful nerve damage, and since it is most prevalent in people over age 65–be a good steward for your clients and recommend this shot. BUT explain that it isn’t free, or even cheap.
Since you are talking about shingles, be aware that the shot is only supposed to last 5 years. If your clients got the old shot, they should probably get the new shot.
If YOU are age 50 or older, get the vaccine and avoid the pain of shingles. I’ve known 6 people who had ranging in age from 36-68 and they all said it was pure hell. Most still feel some nerve damage in the effected area. In other words, even if you have to pay for the shot, it’s worth it to avoid being the 1 in 3 American’s who will contract shingles.