The COVID-19 vaccine has proven to be highly effective in reducing the risk of severe disease, hospitalization, and death, and health officials have recommended older adults receive a booster shot to provide additional protection, especially as new variants emerge.
Medicare covers many preventive services, often at no cost to beneficiaries. This includes several vaccines and immunizations for the flu, pneumonia, hepatitis B, and COVID-19.
Keep reading to get answers to common questions you and your older clients may have about this recommendation, and where to find a COVID booster appointment in your community.
Does Medicare cover the COVID-19 booster shot?
Yes, Original Medicare Part B covers COVID-19 vaccines, including the booster shot, regardless of whether someone has Original Medicare or a Medicare Advantage plan.
How much does the COVID booster cost?
People with Medicare should owe nothing for the shot(s). The Medicare Part B deductible does not apply, and there is no copayment, and the provider cannot charge an administration fee for the booster.
When should older adults receive a booster?
The Centers for Disease Control and Prevention (CDC) recommends that people aged 65 years or older (or 18 years or older and at high risk for getting severe COVID-19) who got a Pfizer or Moderna COVID-19 vaccine get a booster shot at least 6 months after their second dose.
Anyone who received the one-shot Johnson & Johnson COVID-19 vaccine can get a booster shot at least 2 months after their first vaccine.
Which booster shot should older adults get?
The CDC has said that it is fine for people to “mix and match” the specific vaccine type they first received with the booster. So someone who received the Pfizer series for their first two shots can get the Moderna or Johnson & Johnson as their booster. Or they may prefer to stay with the same vaccine manufacturer for all shots. If you or your client are unsure which vaccine to get as a booster, check with their primary care physician or pharmacist.
How can I help clients set up an appointment for a booster shot?
Many health providers, pharmacies, and local health departments have COVID-19 boosters available. Visit www.vaccines.gov to search for a specific vaccine and location near you; appointments are typically available up to two weeks in advance. Be sure to remind your clients to bring their COVID-19 vaccination card and Medicare card to the appointment.
What about homebound seniors? Can they get the vaccine and booster at home?
If you have a client with Medicare who is unable to leave their home due to disability or other challenges, Medicare will pay a doctor or other care provider to give them the COVID-19 vaccine in their home.
Your client should contact their regular health care provider and ask if they’re able to administer the COVID-19 vaccine in their home. They can also call 1-800-MEDICARE for vaccine contacts in your state.
Resources for counselors
- Get tips from the U.S. Administration for Community Living and the No Wrong Door program for how to talk about vaccines within a person-centered decision support approach
- The SHIP Technical Assistance Center offers one-page tip sheets on Medicare coverage of COVID-19 vaccines in multiple languages.
- Learn how to help your older clients stay safe from COVID-19 scams with this guidance from the Senior Medicare Patrol.
- Customize and share these infographics from Resilient American Communities and BellAge that educate older adults about the importance of COVID-19 vaccines.
