What Vaccines Does Medicare Not Cover?

Vaccines Medicare never covers (travel shots)

There is one group of vaccines that no part of Medicare will pay for: vaccines you need for foreign or international travel. Medicare treats these as not 'reasonable and necessary' for treating or preventing illness in the United States, so they are excluded under both Part B and Part D.

If you need one of these for a trip, you pay the full price out of pocket, usually at a travel clinic or health department. Costs commonly run from about $50 to $200 or more per vaccine, and some require more than one dose.

There is no Part D plan or Medicare Advantage plan that turns these into covered benefits — travel vaccines sit outside what Medicare pays for. If you have other coverage (such as an employer plan or travel insurance), check with that plan instead.

• Yellow fever
• Typhoid
• Japanese encephalitis
• Cholera

Shots Original Medicare alone won't cover

Original Medicare means Part A (hospital) and Part B (medical) by themselves, with no drug plan attached. On its own, Original Medicare covers only four preventive vaccines, all under Part B: flu (influenza), pneumococcal (pneumonia), COVID-19, and hepatitis B for people at medium or high risk.

Every other adult vaccine — including the shingles vaccine (Shingrix), the RSV vaccine, and the Tdap shot (tetanus, diphtheria, pertussis) — is a Part D vaccine. That means it is covered only when you have a standalone Part D drug plan or a Medicare Advantage plan that includes drug coverage.

So if you have Original Medicare and no Part D plan, and you go to get a shingles, RSV, or Tdap shot, Medicare will not pay for it and you would be charged the full retail price. The vaccine is not 'uncoverable' — you just need the right kind of plan to access it.

• Shingles (Shingrix) — Part D only, not Original Medicare
• RSV — Part D only, not Part B
• Tdap (tetanus/diphtheria/pertussis) — Part D only, not Part B
• These are $0 with a Part D plan, but full price without one

Which vaccines fall under Part B vs Part D

Knowing which 'bucket' a vaccine falls into tells you which plan has to pay. Part B covers a short, fixed list of preventive vaccines. Part D covers almost everything else that is commercially available — but it specifically does not cover the four Part B vaccines, and it never covers travel vaccines.

This matters because the rules and the cost-sharing are different for each. Part B vaccines are billed through your medical coverage; Part D vaccines are billed through your drug plan.

• Part B vaccines: flu, pneumococcal (pneumonia), COVID-19, and hepatitis B (medium/high risk only)
• Part D vaccines: shingles, RSV, Tdap, and most other commercially available adult vaccines recommended by the CDC's ACIP
• Not covered by either: travel vaccines (yellow fever, typhoid, Japanese encephalitis, cholera)

The hepatitis B exception: who qualifies under Part B

Hepatitis B is the one vaccine where your personal risk level decides whether Part B pays. Part B covers the hepatitis B vaccine only for people at medium or high risk. If you are at low risk, Part B will not cover it.

You are generally considered medium or high risk if you have a condition like diabetes, end-stage renal disease (ESRD), or hemophilia; if you live with someone who has hepatitis B; or if you have certain occupational or health-care exposure.

If you are low risk, you are not stuck. A low-risk person can still get the hepatitis B vaccine covered under a Part D plan instead — it just doesn't come through Part B.

• Covered by Part B if medium/high risk (diabetes, ESRD, hemophilia, household contact, occupational exposure)
• Not covered by Part B if low risk
• Low-risk beneficiaries can still get it covered through Part D

What covered vaccines cost in 2026

For the vaccines Medicare does cover, the good news is that you usually pay nothing. The four Part B preventive vaccines (flu, pneumococcal, COVID-19, and hepatitis B for at-risk people) and their administration are not subject to the Part B deductible or the 20% coinsurance — you pay $0 as long as your provider accepts assignment. As of January 1, 2025, hepatitis B is paid the same $0 way as the other Part B preventive vaccines.

For reference, the standard 2026 Part B premium is $202.90 per month and the Part B annual deductible is $283, with a normal 20% coinsurance — but none of those apply to the covered preventive vaccines above; they remain $0.

On the Part D side, the Inflation Reduction Act made all adult vaccines recommended by the CDC's Advisory Committee on Immunization Practices (ACIP) cost $0 — no deductible, no copay, no coinsurance. This took effect January 1, 2023 and continues for 2026, covering shots like shingles, RSV, and Tdap. The catch is the same as before: you must be enrolled in Part D to get that $0 price. Without Part D, you pay full retail.

• Part B covered vaccines: $0 (deductible and 20% coinsurance do not apply)
• Part D ACIP-recommended adult vaccines: $0 with a Part D plan (shingles, RSV, Tdap, and more)
• Travel vaccines: full out-of-pocket cost, no Medicare help
• No Part D plan: shingles/RSV/Tdap charged at full retail