Medicare vaccine coverage

The 4 Vaccines Seniors Need This Year

Addison McNatt Fitness & Health, Medicare Leave a Comment

Every year when the temperature drops, you begin to hear those dreaded words: flu season. 

Not only does cold weather weaken our immune systems, it can strengthen viruses and make it easier for them to spread. No matter your age, vaccination may be the best safeguard against this bacterial onslaught. But adults over 50 are especially susceptible to the flu virus and many other dangerous infections like pneumonia and tetanus. An estimated 50,000 to 90,000 adults in the United States die from vaccine-preventable diseases every year and the mortality rates increase significantly as we age.

The Most Important Vaccines For Seniors

Luckily, in our current century, vaccinations are widely available for many of these potentially deadly pathogens and the Center for Disease Control recommends a schedule of specific vaccinations for older adults. And for seniors with certain types of Medicare, financial help may even be available to alleviate some of the costs of these immunizations. Here are the four most crucial vaccines for adults over 50.

Influenza (Flu) Shot

Influenza, commonly called the flu, is a viral respiratory infection that can be life-threatening for people of any age. But older adults must be especially cautious, as the normal aging of our immune systems can make it more difficult for our bodies to fight off the infection. It’s even more dangerous for those who live with a chronic condition like heart disease or diabetes, as complications can develop and even lead to hospitalization. In fact, according to the CDC, adults over 65 make up half of all influenza hospitalizations and between 70 to 90% of all flu-related deaths. Be sure to get your flu shot!

Pneumococcal Vaccine

Pneumococcal disease might not be a familiar household name but we have all heard of the conditions that it can lead to: pneumonia and meningitis among others. It is the most common cause of bloodstream infections and can infect the ear and sinuses as well. Like the flu, a weakened immune system and chronic conditions may increase these risks. While these infections can often be mild, pneumonia is actually the 5th most frequent cause of hospitalization in the United States and over half of those are from Americans over 65 years old.

Tetanus (Td) Shot

It’s often referred to simply as a tetanus shot, but the Tdap vaccine also helps our bodies fight off diphtheria and pertussis, or whooping cough. This particular vaccine can usually only be given once but if you never received it as a child, it’s not too late to get yourself immunized. But if those over 65 have already gotten the full Tdap shot, it is recommended that they seek the variety of vaccine called the Td shot every 10 years, which doesn’t include the pertussis component.

Shingles (Zoster) Vaccine

Herpes zoster (or shingles) is a painful skin condition brought on by the same virus that causes chickenpox. It’s common knowledge that individuals who have previously contracted chickenpox have a higher risk of developing shingles, but older people are also more vulnerable than their younger counterparts. Seniors are also more at risk for the complications that can arise from this infection, such as the painful nerve condition called postherpetic neuralgia (PHN). These kinds of complications occur in almost half of older adults who develop shingles.  

When Should Seniors Get Vaccinated?

Though many vaccine-preventable diseases are associated with seasonal changes, most can be contracted at any time of year. To help make sure you are up-to-date with all your immunizations, the CDC keeps the newest recommended vaccine schedule for adults on its website.

Vaccine Schedule For Adults

Experts in this field often suggest vaccination schedules based on age. In some cases, these experts also recommend different varieties of a given vaccine depending on the age of the patient. 

For example, flu vaccines are updated annually to make sure they are effective against the current strains of influenza. Additionally, the immunity provided by the flu shot is short-lived so it is best to get vaccinated every year. Flu vaccines are usually available from September through April depending on supplies. Several different forms of the vaccine exist including two designed specifically for people over 65, namely the “high dose vaccine” and the adjuvanted flu vaccine. 

The shingles vaccine, on the other hand, is not required during a specific season but there are multiple variations available and it may still require a schedule to keep track of. The CDC suggests that healthy adults over 50 get the two-dose version of the vaccine, called the zoster recombinant vaccine (or RZV), as opposed to the single-dose zoster live variant. The two doses are generally spaced out over several months but are roughly 90% effective once they have both been administered.  

Travel Vaccinations

Many seniors take up traveling after retirement has freed up more of their time. Wherever this trekking may take you, it is wise to stay up-to-date on your vaccinations. Certain vaccine-preventable illnesses like measles and seasonal flu are much more prevalent abroad than they are in the States. Check for your destination on the CDC’s website to see what vaccines may be needed where you’re going.

Learn how to get Medicare coverage overseas.

Where Is The Best Place To Get Vaccinated?

Now that you know when to get immunized, you might be wondering where you can get a quick, efficient, and affordable vaccination. This can get somewhat complicated depending on what vaccines you need and what state you live in but most vaccines can be administered at one of the healthcare facilities you visit regularly.

Doctor’s Office 

Doctor explaining Medicare vaccine coverage.

Even though many other options are available, most will likely prefer to get their vaccinations at their regular doctor’s office. Your primary care doctor is a great resource not only for detailed information about what vaccines you or your family may need, but obviously for the administering of the vaccine itself. They can also advise on which variety of a given vaccine is best for you, as well as any side effects that may accompany it. 

Pharmacies & Clinics

For many seniors, the most readily and easily available venue for vaccines is their local pharmacy. These establishments are usually closer to their homes than a doctor’s office or hospital and can provide many of the same vaccinations. It is probably best to call ahead to ensure the pharmacy or clinic is stocked with the vaccine you need as supplies can run low.

Medicare Vaccine Coverage

An often overlooked element of the threat posed by vaccine-preventable diseases is the financial cost. A 2007 study of the seasonal flu found that $87 billion was spent every year on direct and indirect medical costs. It also found that adults over 65 made up about 64% of that cost. Clearly, it is cheaper to get vaccinated than to potentially incur the medical expenses of treating the disease itself but if the cost of immunization still seems daunting, there are options available to help with or completely cover the vaccines.

Does Medicare Pay For Flu Shots?

Flu shots are completely covered by Medicare Part B, as they are categorized as a preventive service. As long as your healthcare provider accepts Medicare, your annual flu shot will be a cost-free benefit. For those who are enrolled in a Medicare Advantage plan, you may need to see an in-network doctor or pharmacy to be totally covered. This complete coverage applies to the pneumococcal vaccine as well!

Does Medicare Pay For Shingles Vaccine?

Medicare Part D plans, which are Medicare Advantage plans that cover prescription drugs, virtually all cover the shingles vaccine. As these are supplemental plans, an out-of-pocket cost is usually associated with these vaccinations. Whether this is in the form of a copayment or coinsurance, it is best to contact your insurance provider directly to discuss the potential out-of-pocket cost, as well as any specific rules they might have for the administering of the vaccine itself.

Turning 65 Checklist
Turning 65 Checklist

Does Medicare Pay For Tetanus Shots?

Like the shingles vaccine, neither Td and Tdap versions of the tetanus shot are covered by Medicare Part B. These vaccines will need to be covered by an insurance plan that includes prescription drug coverage, such as Medicare Part D. These plans are purchased through private insurance companies and supplement the coverage provided by the original components of Medicare. 

Depending on where you live, there could be countless Medicare Advantage plan options available and finding the one that best suits you can be exhausting and outright confusing. Take out some of the guesswork and get in touch with a licensed agent through Medicare Plan Finder today to find the best plan for your needs! Call us at 833-438-3676 or contact us online to get started!