Coronavirus disease 2019 (COVID-19) vaccine
Medicare covers the updated (2023–2024 formula) Moderna or Pfizer-BioNTech COVID-19 vaccine for anyone who has Medicare. (If you recently had COVID-19, the CDC recommends you wait at least 3 months before you get the updated COVID-19 vaccine.)
The updated 2023–2024 Pfizer-BioNTech or Moderna vaccine is available for people 5 and older.
If you’re 65 or older and/or immunocompromised (like people who have had an organ transplant and are at risk for infections and other diseases), you can get a 3-dose series of updated (2023–2024 formula) Moderna or Pfizer-BioNTech COVID-19 vaccine. If you had doses of a Moderna or Pfizer-BioNTech COVID-19 vaccine in the past, you can get 1 or 2 doses of the updated formula, depending on how many doses you had in the past. Check CDC.gov to find your vaccination schedule.
Your costs in Original Medicare
You pay nothing for the COVID-19 vaccine if your doctor or other health care provider accepts assignment for giving you the shot.
What it is
A COVID-19 vaccine helps reduce the risk of illness from COVID-19 by working with the body’s natural defenses to safely develop immunity (protection) against the virus. COVID-19 vaccines are safe and effective. Get details about the vaccine.
Things to know
- Find a COVID-19 vaccine near you.
- Be sure to bring your red, white, and blue Medicare card with you when you get the vaccine so your health care provider or pharmacy can bill Medicare.
- If you're in a Medicare Advantage Plan, you must use the card from your plan to get your Medicare-covered services. You pay nothing when you get the vaccine from an in-network provider. Check with your plan for more information.
- If you fill out a form to get the vaccine, you might be asked for your insurer’s group number. If you have Part B, leave this field blank or write “N/A.” If you have trouble with the form, talk with your vaccine provider.
- Medicare also covers:
- Lab tests for COVID-19. Part B covers COVID-19 diagnostic tests without cost sharing when ordered by a health care provider and done by a laboratory. Some Medicare Advantage Plans might require you to pay part of the cost.
- Oral antivirals. If you test positive for COVID-19 and have mild to moderate symptoms, but are at high risk for getting very sick from COVID-19, you may be eligible for oral antiviral treatment. Medicare Part D covers oral antiviral treatment. Your plan's deductible, copayment, and coinsurance rules apply.
- FDA-authorized COVID-19 antibody (or “serology”) tests if you were diagnosed with a known current or known prior COVID-19 infection or suspected current or suspected past COVID-19 infection.
- Monoclonal antibody treatments for COVID-19.
- All medically necessary hospitalizations. This includes if you're diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine. You’ll still pay for any hospital deductibles, copays, or coinsurance that apply.
- Expanded telehealth services through December 31, 2024.
Note: Military hospital ships and temporary military hospitals don’t charge Medicare or civilians for care. If you aren't sure whether the hospital will charge you, ask them. - If you're in a Medicare Advantage Plan, you might have access to these same benefits. Check with your plan about your coverage and costs.
Getting the COVID-19 vaccine in your home
If you have Medicare and have a disability or face other challenges in getting to a location away from home for a vaccination, Medicare will pay a doctor or other care provider to give you the COVID-19 vaccine in your home. You may need to give them your Medicare Number for billing, but there’s still no cost to you for the vaccine and its administration.
Contact your regular doctor or health care provider and ask if they’re able to give you the COVID-19 vaccine in your home. If they can’t, they might be able to refer you to someone who can do this. You can also call 1-800-MEDICARE (1-800-633-4227) for vaccine contacts in your state. TTY users can call 1-877-486-2048. More details on providers of the COVID-19 vaccine are also available on Vaccines.gov.
Remember, don’t give out your Medicare Number or accept a vaccine from anyone who isn’t a known or trusted provider, or who contacts you without your invitation.
If you paid to get a COVID-19 vaccine
When you get a COVID-19 vaccine, your provider can’t charge you for an office visit or other fee if the vaccine is the only medical service you get. If you get other medical services at the same time you get the COVID-19 vaccine, you may owe a copayment or deductible for those services.
If you paid a fee or got a bill for a COVID-19 vaccine, check this list to see if your provider should have charged you:
- Check the receipts and statements you get from your provider for any mistakes.
- Call your provider’s office to ask about any charges you think are incorrect. The person you speak to may help you better understand the services you got, or realize they made a billing error.
- If you have Original Medicare, review your “Medicare Summary Notice” for errors. Report anything suspicious to Medicare by calling 1-800-MEDICARE (1-800-633-4227).
- If you have other coverage like a Medicare Advantage Plan, review your “Explanation of Benefits.” Report anything suspicious to your insurer.
If you think your provider incorrectly charged you for the COVID-19 vaccine, ask them for a refund. If you think your provider charged you for an office visit or other fee, but the only service you got was a COVID-19 vaccine, report them to the Office of the Inspector General, U.S. Department of Health and Human Services by calling 1-800-HHS-TIPS or visiting https://oig.hhs.gov/fraud/report-fraud/.