Does Medicare Cover the RSV Vaccine?

Is the RSV vaccine covered by Medicare?

Yes. The RSV (respiratory syncytial virus) vaccine is covered by Medicare. It is one of the adult vaccines recommended by the CDC's Advisory Committee on Immunization Practices (ACIP), and Medicare covers those vaccines.

The important detail is which part of Medicare covers it. The RSV vaccine is covered under Part D (prescription drug coverage), not Part B. This is different from vaccines like the flu shot, COVID-19 shot, and pneumonia shot, which fall under Part B. Because Part B does not cover the RSV vaccine, you need drug coverage to get it through Medicare.

Part B or Part D — which one pays?

The RSV vaccine is a Part D benefit. Part B covers a short list of vaccines (flu, COVID-19, pneumococcal, and hepatitis B for people at risk), but RSV is not on that Part B list. Instead, Part D covers the ACIP-recommended adult vaccines that Part B does not — including RSV, shingles, and Tdap (whooping cough).

• Standalone Part D drug plan — covers the RSV vaccine at $0.
• Medicare Advantage plan with drug coverage (MA-PD) — covers the RSV vaccine at $0 through its built-in Part D benefit.
• Original Medicare alone (Part A and Part B only, no drug plan) — does NOT cover the RSV vaccine. You would need to add a Part D plan or switch to an MA-PD plan to get it covered.

How much does the RSV vaccine cost with Medicare?

If you have Part D coverage, the RSV vaccine costs you $0 — no copayment and no deductible. This applies even if you have not yet met your plan's annual drug deductible.

This free coverage is the law. Section 11401 of the Inflation Reduction Act amended the Social Security Act so that, effective January 1, 2023, no deductible or cost-sharing applies to adult vaccines recommended by ACIP that are covered under Part D. That is why the RSV vaccine — and other ACIP adult vaccines like shingles and Tdap — are now free for people with Part D.

For comparison, the adult RSV vaccine can cost roughly $150 to $300 out of pocket without insurance, depending on the specific vaccine and pharmacy. That is the kind of cost Part D's $0 cost-sharing rule saves you.

Who is eligible — what ages and conditions?

The CDC's recommendations determine who should get the RSV vaccine, and Medicare coverage follows those recommendations.

Note: In 2025 the CDC lowered the minimum age for high-risk adults from 60 to 50, so the increased-risk group is now 50–74 (previously 60–74).

• All adults 75 and older — recommended a single dose, regardless of risk.
• Adults 50–74 at increased risk of severe RSV disease — recommended a single dose. Increased-risk conditions include chronic lung disease (such as COPD or asthma), chronic heart disease, diabetes (especially with complications or insulin use), chronic kidney disease or dialysis, chronic liver disease, severe obesity, a weakened immune system, certain neurologic or blood disorders, and living in a nursing home or other long-term care facility.
• It is a one-time dose, not an annual shot. Under current recommendations, eligible adults do not need a new dose every RSV season.
• Talk with your doctor or pharmacist about whether you qualify, especially if you are 50–74 and unsure whether you are considered high-risk — your provider can determine your risk.

Where and when to get the RSV vaccine

You can get the RSV vaccine in many places, including a doctor's office and a local pharmacy. Because it is covered under Part D, the most reliable way to get it at $0 is to use a pharmacy that is in your Part D plan's network. Using an in-network pharmacy helps make sure the claim is processed correctly under your drug benefit.

On timing, the CDC says the vaccine has the most benefit when given in late summer or early fall, just before RSV season — roughly August to October in most of the continental U.S. Since it is a one-time dose, getting it ahead of the season helps protect you when RSV is circulating most.

A note on Part D premiums (the shot is still free)

To have RSV coverage you must be enrolled in Part D, which carries its own monthly premium. The 2026 national base beneficiary premium for Part D is $38.99 per month, though your actual premium depends on the plan you choose. The vaccine itself is still $0 regardless of your premium.

For reference, the standard 2026 Part B premium is $202.90 per month — but remember, Part B is not what covers the RSV vaccine. If you only have Part A and Part B and no drug plan, the RSV vaccine will not be covered, so consider whether a Part D or Medicare Advantage plan fits your needs.

Plans, networks, and pharmacy options vary. Always confirm details with your specific plan's Evidence of Coverage or by calling the number on your plan card.