Published by: Medicare Rights Center
Earlier this year, the Food and Drug Administration (FDA) approved the RSV vaccine. According to the Centers for Disease Control and Prevention, the RSV vaccine can help prevent lower respiratory tract disease caused by respiratory syncytial virus (RSV). RSV season varies from year to year but usually starts in the fall and peaks in the winter. RSV can affect people of all ages but may be especially serious for infants and older adults.
Medicare Part D covers the RSV vaccine if it’s recommended for you by the Advisory Committee on Immunization Practices (ACIP), a government agency that gives advice about who should get certain vaccines. At this time, the RSV vaccine is recommended for adults over the age of 60.
There should be no cost to you to get this vaccine. This means your pharmacy shouldn’t charge you a copay or deductible to get the RSV vaccine. If you have Medicare Part D, it should be free to you.
If you have Medicare Part D and your doctor or pharmacy tries to charge you for the RSV vaccine, you should call 1-800-MEDICARE (1-800-633-4227) for help.
If you have non-Medicare drug coverage (like drug coverage from an employer or union), you should check to see its coverage rules for the RSV vaccine. Because this is a newer vaccine, it may not be listed on an insurance plan’s list of covered drugs yet, so you should check with your plan before making an appointment.
Remember that while the RSV vaccine is covered by Part D, your flu and COVID-19 vaccines will still be covered by Part B.