There are a lot of questions that go into planning for retirement, and some of those questions concern healthcare costs. Among the more simple, straightforward questions many people have is this one: Does Medicare cover flu shots? The basic answer is, Yes. But to understand flu shot coverage, we need to do a basic lesson in Medicare 101.
A lot of supplemental types of insurance have been added to the world of Medicare, but the essential program known as Original Medicare, is made up of two parts:
Medicare Part A: Hospital insurance that covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some in-home care. Most people receive Medicare Part A without paying a premium.
Medicare Part B: Medical insurance that covers certain doctors services, outpatient care, medical supplies and preventive services. Some people get Medicare Part B without paying a premium, but most people do pay a premium.
Another essential of Medicare to keep in mind is that you need to enroll. There are some special circumstances under which certain people are automatically enrolled, but that isnt the case for most. Plus, you need to enroll in Parts A and B separately. To get an understanding of Medicare eligibility requirements and whether or not you can expect to be paying premiums, visit the U.S. governments Medicare website.
Flu Shot Coverage
A flu shot is a preventive service under Medicare Part B, which means you need to proactively enroll in Part B and, most likely, be paying a premium for your Part B coverage (a premium based on your income).
Anyone with Medicare Part B coverage is entitled to one free flu shot each season. Before getting your shot, however, make sure the doctor or other qualified healthcare provider giving you the shot accepts assignment from Medicare. Accepts assignment means the provider has agreed to 1) will administer flu shots to Medicare patients for the fee that has been set by Medicare, 2) will receive payment directly from Medicare and not from the patient.
Please keep in mind a flu shot being covered does not mean all of your drug needs are covered; coverage for prescription drugs and, for that matter, many other treatments/services are where the various other types of Medicare supplement insurance come into play.
About the Flu Shot Itself
Weve looked at the question of whether or not flu shots are covered under Medicare, but there are some questions you might have about the shot in general. Here are some common questions, addressed with answers based on information from the U.S. Centers for Disease Control and Prevention (CDC):
Why should I get a seasonal flu shot? The flu (influenza) is a lot more than just another simple malady of the season like colds and coughs. It can be life-threatening. Every year, millions of people get the flu, hundreds of thousands are hospitalized because of it and thousands, even tens of thousands die from flu-related causes. An annual seasonal flu shot is the best way to protect yourself.
Can I get the flu, even if I have a seasonal flu shot? Yes, that can happen. It takes about two weeks for a flu vaccine to take effect. You can develop flu if exposed to it shortly after your shot. You may also find yourself exposed to a strain of flu that the seasonal shot isnt designed to cover; seasonal vaccines are based on research into what the most likely forms of flu are for a given season. In addition, the level of protection a flu shot provides can vary based on your overall health; if your immune system has been weakened, for instance, you may be more susceptible to the flu, even with a flu shot.
If I can still get the flu, why get a flu shot? Coming down with the flu, in spite of having gotten a flu shot, is aggravating, without a doubt. But studies have shown getting a flu shot can actually reduce how severe a post-vaccine bout with the flu can be.
Still Have Questions?
Good. As with anything we discuss on the SelectQuote blog, your decision about a flu shot should be an informed one. Check out the CDCs informative webpage about who should and shouldnt get a flu shot. There are other aspects of flu prevention, too. And theyre very easy to work into your daily routine.
Whether youre planning your first Medicare-covered flu shot this year or simply looking forward to one down the road, as part of well-deserved future retirement, all of us at SelectQuote wish you a very healthy flu season.