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How to Pay for Vaccines

Key points

Information about paying for vaccines with private insurance, Medicare, and Medicaid. Options for military personnel, and people without health insurance are also covered.

Private Insurance

All Health Insurance Marketplace plans and most other private insurance plans must cover certain vaccines without charging a copayment or coinsurance when provided by an in-network provider. This is true even for patients who have not met a yearly deductible. Doses, recommended ages, and recommended populations for vaccinations vary. The following vaccines are usually covered by health insurance:

  • COVID-19
  • Haemophilus influenzae type b
  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster
  • Human Papillomavirus
  • Influenza
  • Measles, Mumps, Rubella
  • Meningococcal
  • Pneumococcal
  • RSV
  • Tetanus, Diphtheria, Pertussis
  • Varicella

Check with your insurance provider for coverage details. Under the Affordable Care Act, insurance plans that cover children allow parents to add or keep adult children on their health insurance policy until they turn 26 years old.

RSV Vaccine‎

Everyone ages 75 and older should get a respiratory syncytial virus (RSV) vaccine. CDC also recommends adults ages 60-74 who are at increased risk of severe RSV disease get an RSV vaccine.


Private health plans are required to cover new vaccine recommendations in the next plan year however some insurance plans may cover them in the current plan year. Check with your insurance provider for details on whether there is any cost to you for recommended vaccines.

Medicare

Medicare Part B plan will pay for the following:

Medicare Part D plans make all adult vaccines recommended by the Advisory Committee on Immunization Practice (except those covered by Part B) available at no cost, including:

  • RSV
  • Zoster (shingles) vaccine

Even if a particular drug plan's formulary doesn't list all Part D vaccines, it must provide access when a physician prescribes a Part D vaccine.

Contact your plan to find out about coverage.

Medicaid

Beginning October 1, 2023 most adults with coverage from Medicaid and CHIP will be guaranteed coverage of all vaccines recommended by the Advisory Committee on Immunization Practice at no cost to them.

Military

If you serve in the military or are a military dependent, you are eligible for TRICARE. Under TRICARE, vaccines are covered according to the CDC recommended schedule.

No Insurance?

Adults

If you do not currently have health insurance, visit www.HealthCare.gov to learn more about affordable health coverage options.

There will be 2024-2025 COVID-19 vaccine available through state health department immunization programs for uninsured individuals, though availability will be limited compared to prior years. Although some manufacturers may be working toward establishing patient assistance programs for adults seeking COVID-19 vaccination in the 2024-2025 season, no such programs have yet been announced.

Children

CDC's Vaccines for Children (VFC) program provides vaccines at no cost to eligible children through health care providers enrolled in the program.

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Content Source:
National Center for Immunization and Respiratory Diseases (NCIRD)