Does Medicare Cover the Pneumonia Vaccine?
Yes. Medicare Part B (Medical Insurance) covers pneumococcal — commonly called pneumonia — shots as a preventive service, and you pay nothing for the vaccine or its administration as long as your doctor or provider accepts Medicare assignment. The Part B deductible and 20% coinsurance do not apply to this vaccine. Medicare covers a first dose at any time and a different second dose if it is given at least one year later. Note that the pneumonia vaccine falls under Part B (medical), not Part D (drug coverage).
Is the pneumonia vaccine covered, and what does it cost?
Medicare Part B covers pneumococcal (pneumonia) vaccines as a preventive service. When your doctor, pharmacy, or other provider accepts Medicare assignment — meaning they agree to the Medicare-approved amount as full payment — you pay $0 for the shot.
This is one of a small group of vaccines Medicare covers in full as preventive care, alongside the COVID-19, flu, and hepatitis B shots. For these vaccines, neither the Part B deductible nor the 20% coinsurance applies. The coinsurance and deductible are waived for both the vaccine itself and the cost of administering it.
For context, the figures the pneumonia vaccine is exempt from in 2026 are the standard Part B premium of $202.90 per month, the annual Part B deductible of $283, and the usual 20% coinsurance. None of these apply to this vaccine when assignment is accepted. (You still pay your normal monthly Part B premium to keep your coverage — that premium is separate from any cost for the shot.)
Part B, not Part D — why that matters
The pneumonia vaccine is covered under Part B (medical insurance), not Part D (prescription drug coverage). This is different from several other vaccines — for example, the shingles and Tdap (tetanus, diphtheria, whooping cough) shots are generally covered under Part D.
The practical takeaway: you do not need a Part D drug plan to get your pneumonia shot covered. Part B handles it. Because it is a Part B preventive service, the $0 cost depends on the provider accepting assignment rather than on a drug plan's formulary or pharmacy tiers.
How many shots, which vaccines, and second doses
Medicare covers a first pneumococcal dose at any time, and it covers a different second dose if that dose is given at least one year after the first. Whether you need one or two doses, and which specific vaccine is right for you, is a decision to make with your doctor based on current CDC guidance for your age and health.
Medicare Part B covers both of the main types of pneumococcal vaccine — the conjugate vaccines (PCV) and the polysaccharide vaccine (PPSV23):
- PCV21 — Capvaxive (billing code CPT 90684)
- PCV20 — Prevnar 20 (CPT 90677)
- PCV15 — Vaxneuvance (CPT 90671)
- PCV13 — Prevnar 13, the older conjugate vaccine (CPT 90670)
- PPSV23 — Pneumovax 23, the polysaccharide vaccine (CPT 90732)
Where to get it and who to see
You can get a Medicare-covered pneumonia shot at a doctor's office, a clinic, or many pharmacies. The key to paying $0 is making sure the provider accepts Medicare assignment. If a provider does not accept assignment, you could be charged more, so it is worth asking before you get the shot.
Pharmacies can be a convenient option, but confirm in advance that the pharmacy bills Medicare Part B for the pneumococcal vaccine (rather than billing it as a drug-plan claim). A quick phone call to ask 'Do you accept Medicare assignment and bill Part B for the pneumonia shot?' can prevent a surprise bill.
What if I have Medicare Advantage (Part C)?
Medicare Advantage (Part C) plans are required to cover the pneumococcal vaccine because it is a Part B preventive service. In most Advantage plans the shot is $0, just as it is under Original Medicare.
The difference is that Advantage plans use provider networks and set their own rules. To get the shot at no cost, you may need to use an in-network provider or pharmacy, and details can vary from plan to plan. Check your plan's materials — or call the number on your member ID card — to confirm where to go and what, if anything, you will pay. When in doubt, confirm coverage details with your specific plan before getting vaccinated.
What the pneumonia vaccine protects against
The pneumococcal vaccine protects against strains of the bacterium Streptococcus pneumoniae. These bacteria can cause pneumonia, but they can also lead to more serious infections including meningitis (infection of the lining of the brain and spinal cord) and bacteremia (a bloodstream infection).
Because these illnesses can be especially dangerous for older adults, your doctor can tell you whether — and when — the vaccine is recommended for you based on your age, health conditions, and current CDC guidance.
Frequently asked questions
How much does the pneumonia vaccine cost with Medicare?
You pay $0 — nothing for the vaccine or its administration — as long as your doctor, pharmacy, or other provider accepts Medicare assignment. The Part B deductible and the 20% coinsurance do not apply to this preventive vaccine.
Which part of Medicare covers the pneumonia shot?
Part B (Medical Insurance) covers the pneumococcal vaccine, not Part D (drug coverage). This is different from some other vaccines, such as shingles and Tdap, which are usually covered under Part D.
How many pneumonia shots does Medicare cover?
Medicare covers a first pneumococcal dose at any time and a different second dose if it is given at least one year after the first. Talk with your doctor about whether you need one or two doses based on current CDC guidance for your situation.
Which pneumonia vaccines does Medicare cover?
Part B covers the conjugate vaccines PCV21 (Capvaxive), PCV20 (Prevnar 20), PCV15 (Vaxneuvance), and the older PCV13 (Prevnar 13), as well as the polysaccharide vaccine PPSV23 (Pneumovax 23).
Does Medicare Advantage cover the pneumonia vaccine?
Yes. Medicare Advantage (Part C) plans must cover the pneumococcal vaccine, and it is usually $0. However, you may need to use an in-network provider, and rules can vary by plan, so check your plan's materials or call the number on your ID card to confirm.
Do I have to pay the Part B deductible or 20% coinsurance for the pneumonia shot?
No. The Part B deductible and the 20% coinsurance are both waived for the pneumococcal vaccine and its administration, so you owe nothing when the provider accepts assignment.
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Medicare Login Guide is an independent resource and is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, or any government agency. This article is for general information only — confirm current figures and your specific options at medicare.gov or by calling 1-800-MEDICARE.