Vaccinations: What Medicare Covers At No Charge

Vaccination

August might still feel like pool-weather, but it’s the perfect month to lock in the vaccines that will carry you safely through flu-season and the winter COVID-wave—and, new this year for many of us, RSV protection. Here’s the quick low-down for Medicare beneficiaries 65-plus (and younger friends with certain conditions).


Why Book in August?

  • Peak protection on time. It takes about two weeks for your immune system to build top-shelf antibodies after a shot, so an August/September appointment means you’re covered before viruses start circulating in earnest.
  • Appointment sanity. Pharmacies get slammed once Labor Day hits. Scheduling now means shorter lines and a better shot (pun intended) at the high-dose or adjuvanted flu vaccine designed for older adults.

1. Flu Shot — Aim for September, No Later Than Halloween

What’s new?Why it matters
2025-26 formula: The WHO updated the H3N2 component—your vaccine is tailor-made for the strains experts expect to dominate.A better match means fewer breakthrough infections.
“Senior-strength” options: High-dose, adjuvanted, or recombinant versions generate a stronger immune response in folks 65+.Up to 24% better protection against flu-related hospitalizations.

Cost check: Medicare Part B covers the flu shot (and its administration) every season—zero deductible, zero copay, as long as your provider accepts assignment.


2. COVID-19 Booster — The “Twin-Dose” Rule for 65+

  • ACIP guidance: Adults 65+ should receive two doses of the 2024-25/25-26 updated vaccine formula—dose #2 at least 6 months after #1.
  • Expected timing: FDA sign-off on the 2025-26 formulation is projected for early September; many pharmacies allow you to preregister now.
  • Coverage: Like the flu shot, COVID-19 vaccines fall under Part B—no out-of-pocket cost if your pharmacy or clinic takes Medicare.

Pro tip: If you had COVID recently, CDC still recommends waiting about three months before boosting to maximize antibody response.


3. RSV Vaccine — A One-and-Done Shield

  • Who’s eligible?
    • All adults 75+, plus ages 50–74 with heart, lung, diabetes, kidney, liver, obesity, or immune-compromise concerns.
  • Best window: Late summer to early fall—**August → October—**before typical RSV season ramps up.
  • Brands on the shelf: Arexvy (GSK), Abrysvo (Pfizer), and the new mResvia (Moderna). One dose is all you need for multi-year protection.
  • Cost: RSV shots bill to Part D (your prescription plan). Many Medicare Advantage plans and standalone Part D plans place them in a low-tier or $0 copay slot—double-check with your broker first.

4. Can I Get Them All at Once?

Yep. CDC says it’s fine to roll up one sleeve (or two) for a flu + COVID + RSV combo visit; mild arm soreness is the usual side effect, and bundling saves you an extra trip.


Action Steps

  1. Call your pharmacy or clinic today and ask which high-dose flu, updated COVID, and RSV vaccines they’ll stock.
  2. Verify coverage: Your broker can confirm whether your Part D formulary or Medicare Advantage OTC allowance covers RSV, and make sure the pharmacy is in-network.
  3. Mark the calendar: Aim for a single visit in late August or early September—then forget about it until pumpkin-pie season.

Questions About Coverage or Which Vaccines Are Right for You?

That’s exactly what your broker is here for. Reach out anytime—we’ll help you sort through plan perks, pharmacy networks, and the fine print so you can focus on enjoying a healthy, worry-free fall.

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