Dear Marci,

My doctor told me that Medicare Part B will pay for me to get certain vaccines as preventive care, and that I would not have to pay for these vaccines. I’m especially concerned about the flu vaccine, since it is now flu season. Can you explain how Medicare covers these preventive services vaccines?

– Victor (San Antonio, TX)

Dear Victor,

Medicare Part B covers three vaccines as part ofpreventive care services: the flu vaccine, the pneumonia vaccine, and the hepatitis B vaccine. These vaccines are covered by in full, whether you have Original Medicare—the traditional program administered directly by the federal government—or a Medicare Advantage plan. Preventive care vaccines are an important part of staying healthy, and it is important to discuss these vaccines with your doctor.

The flu vaccine is covered once per flu season. The flu season typically runs from October through April. Therefore, Medicare may cover a flu shot twice in one calendar year. For example, if you get a flu shot in February 2014 for the 2013-2014 flu season, you can get another flu shot in November 2014 for the 2014-2015 flu season. Original Medicare will pay for the flu shot anywhere you receive it, as long as you get it from a Medicare provider. If you have a Medicare Advantage plan, your plan cannot require that you get a referral for the vaccine, but you may be required to use providers in the plan’s network.

The pneumonia vaccine is covered in full by Medicare once in your lifetime. However, in rare cases, Medicare will cover this shot more than once in a lifetime. If you are at high risk for pneumonia, meaning that you have an immunodeficiency, Medicare may cover this shot in full once every five years. Speak with your doctor if you think you are considered high risk for pneumonia. Medicare Part B covers the pneumococcal vaccine for pneumonia.

Medicare will also cover the entire cost of the hepatitis B vaccine if you are considered at medium to high risk for the disease. Some examples of individuals who are at medium to high risk for hepatitis B are people with End-Stage Renal Disease (ESRD), hemophiliacs, and those healthcare professionals who have contact with bodily fluids during their work. Speak with your doctor if you think you are at risk for hepatitis B. If you are at low risk for the disease, you can still get the hepatitis B vaccine, but it will be covered by your Part D plan, and you will likely have to pay a copay.

If you have Original Medicare, the best way to avoid additional charges is to see a health care provider whoaccepts Medicare assignment when receiving these vaccines. To avoid additional charges if you have a Medicare Advantage plan, check with your plan to make sure you follow their rules about receiving vaccines.

-Marci