Prescription Costs & Part D
Are vaccines free under Medicare?
Last reviewed: · Big Sioux Benefits Data Desk
Adult vaccines recommended by the CDC's Advisory Committee on Immunization Practices and covered under Part D now cost you $0, with no deductible applied. The shingles vaccine is the headline example, since it commonly ran well over a hundred dollars out of pocket before this change. Separately, flu, pneumococcal, COVID-19, and hepatitis B vaccines for people at increased risk are covered under Part B, also at no cost when you use a provider who accepts assignment.
The qualifier: free depends on the vaccine being billed correctly to the right part of Medicare, and on where you get it. A Part D vaccine should be billed through your drug plan, which pharmacies handle routinely. A Part B vaccine billed by a provider who does not accept assignment can leave you owing something. If you are asked to pay full price at a pharmacy counter for a shingles vaccine in 2026, something is being billed wrong, and it is worth stopping to ask rather than paying.
Which vaccines, which part
| Vaccine | Covered under | Your cost |
|---|---|---|
| Shingles | Part D | $0, no deductible |
| Tdap (tetanus, diphtheria, pertussis) | Part D | $0, no deductible |
| Flu | Part B | $0 with a provider who accepts assignment |
| Pneumococcal | Part B | $0 with a provider who accepts assignment |
| COVID-19 | Part B | $0 with a provider who accepts assignment |
| Hepatitis B, for those at increased risk | Part B | $0 with a provider who accepts assignment |
This is one of the few places in Medicare where the answer is simply that it costs nothing, and it is worth acting on, because uptake of the shingles vaccine among older adults has historically lagged largely on cost. If a pharmacy quotes you a price, ask them to run it through your Part D plan rather than as a cash transaction. The broader split between the two parts is in Part B versus Part D drugs.
Sources
- Medicare.gov — What Medicare Part D drug plans cover — accessed 2026-08-21
- Medicare.gov — Costs for Medicare drug coverage — accessed 2026-08-21
- CMS — 2026 Medicare Parts A & B Premiums and Deductibles — November 14, 2025; accessed 2026-08-21
Related questions
Is the shingles vaccine really free with Medicare now?
Yes, when it is billed through your Part D drug plan. Recommended adult vaccines covered under Part D carry no cost sharing and no deductible. If a pharmacy asks you to pay out of pocket, ask them to process it through your drug plan instead of as a cash sale.
What if I do not have a Part D plan?
Then Part D vaccines such as shingles are not covered for you, and you would pay cash. Part B vaccines including flu, pneumococcal, and COVID-19 are still covered, because they run through Part B rather than a drug plan. This is one of the quieter costs of skipping drug coverage.
Drug costs turn on your specific prescriptions, so the arithmetic is worth doing once, properly: book a free, no-pressure conversation, see your county's South Dakota plan lineup, or browse all answers. SHIINE, the state's free counseling program, is at 1-800-536-8197 and sells nothing.
Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or SHIINE (South Dakota's SHIP) for all of your options.