Flu season is here. Are you ready? One of the best ways to be prepared and protected is with a flu shot. But where do you get it, how effective is it, and will Medicare cover it? The experts at Wandacare are here to answer your Medicare-related flu shot questions.
The Importance of Flu Vaccination
You may have heard people say, “Oh, it’s just the flu.” But it’s never just the flu. The U.S. Centers for Disease Control and Prevention (CDC) estimates that influenza caused approximately 21,000 deaths in the United States during the 2022-2023 flu season. Over 70% of these deaths were people aged 65 or older.
Seniors are at greater risk for not only contracting influenza but for developing serious flu complications, as the immune system’s defenses weaken with age, leaving them more susceptible. That’s why vaccines and vaccine boosters are one of the most effective ways to protect high-risk groups like seniors. In fact, the CDC recommends that people 65 and older receive higher dose flu vaccines or adjuvanted inactivated flu vaccines over standard-dose unadjuvanted flu vaccines, as these vaccines are potentially more effective.
How effective your flu shot is can depend on several factors, including your age and health, the type of vaccine, and the strain of flu. For people 65 and older, the vaccine’s effectiveness in preventing severe influenza symptoms and hospitalization is over 50%, and it’s especially potent against influenza B, with a vaccine effectiveness of nearly 80%.
While the flu shot doesn’t guarantee 100% absolute effectiveness and protection (no vaccine does), don’t use that as an excuse to not get one. If you’re 65 or older, the flu shot can help to significantly reduce the severity of your illness if you do get the flu, preventing hospitalization and even death.
Does Medicare Cover Vaccines?
With vaccines being so important in preventing disease and illness in seniors, Medicare covers all the vaccines recommended by the CDC for adults ages 65 and older, including the flu shot. However, the different vaccines are covered under different “parts” of Medicare.
Medicare Part B covers your flu shot, along with the vaccines for COVID-19, pneumonia, and hepatitis B as part of its coverage for preventative care and services. All other vaccines “prescribed by a physician to prevent a patient’s illness” are covered by your Medicare Part D prescription drug plan. This includes the CDC-recommended shingles vaccine, Tdap (tetanus, diphtheria, and whooping cough) or Td (tetanus and diphtheria) vaccines, as well as the vaccine for respiratory syncytial virus (RSV), suggested for adults aged 60 years or older.
Medicare Coverage for the Flu Shot
Medicare Part B fully covers the cost of an annual flu shot, with no copayment or deductible requirement, through any healthcare provider who accepts Medicare. This includes many pharmacies and walk-in clinics where you can get your Medicare-covered flu shot without an appointment. The annual benefit entitles you to one shot per flu season, which runs from October through May, but Medicare will cover an additional flu vaccine if a second shot is deemed medically necessary during the same season.
If you have a private Medicare Advantage Plan (Medicare Part C), you have the same covered benefits as Original Medicare (Parts A and B). However, your flu shot may only be covered if you go to a doctor, clinic, pharmacy, or other medical facility that is in your plan’s network of preferred providers. So be sure to check with your plan. Additionally, many community clinics and public health departments offer free or low-cost flu shots on a walk-in basis.
Staying Healthy During Flu Season
The CDC recommends that you get your flu shot by the end of October, at the start of the annual flu season. While the flu shot is your best shot at reducing your risk for seasonal flu, there are also actions you can take to help protect yourself and others. The CDC recommends taking these preventative measures:
- Avoiding people who are sick
- Staying home when you are sick
- Covering your mouth and nose when you cough and sneeze
- Washing your hands frequently
- Not touching your hands to your eyes, nose or mouth
- Cleaning common and frequently touched surfaces
- Purifying indoor air and getting more fresh, outdoor air
Also, take care of your health throughout flu season by getting plenty of sleep, being physically active, lowering your stress levels, drinking plenty of fluids, and eating nutritious foods.
Navigate Medicare Coverage with Expert Support
Getting your annual flu shot can help you maintain your health throughout flu season and beyond. When you know and understand your Medicare coverage benefits and options, you can make informed decisions for your healthcare needs. Wandacare’s team of licensed Medicare advisors is here with expert guidance for your Medicare journey.
