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By Jim Miller 

What types of vaccinations are recommended for seniors? I know about flu shots, but what else is recommended and what’s covered by Medicare?

 

July 3, 2012



Dear Sally,

Most people think that vaccinations are just for kids, but adults, especially seniors, need their shots too. Here’s a breakdown of what vaccines the Centers for Disease Control and Prevention (CDC) recommends for adults age 50 and older, and how they’re covered by Medicare.

Influenza (flu): While you already know that seasonal flu shots are recommended to everyone age 50 and older, you may not know that seniors over 65 now have the option of getting a new high-potency flu vaccine instead of a regular flu shot. This vaccine – known as the Fluzone High-Dose – creates a stronger immune response for better protection. All annual flu shots are covered under Medicare Part B.

Pneumococcal: Pneumonia causes more than 40,000 deaths in the U.S. each year, many of which could be prevented by the pneumococcal polysaccharide vaccine. Everyone age 65 or older needs to get this one-time vaccination, as well as those under 65 who smoke or have chronic health conditions like asthma, lung and heart disease, diabetes, or a weakened immune system. This vaccination is also covered under Medicare Part B.

Zoster (shingles): Recommended for everyone age 60 and older, shingles is a painful, blistering skin rash that affects more than 1 million Americans each year. All Medicare Part D prescription drug plans cover this one-time vaccination, but coverage amounts and reimbursement rules vary depending on where the shot is given. Be sure you check your plan. If you aren’t covered you can expect to pay between $150 and $250.

Tdap (tetanus-diphtheria-pertussis): A one-time dose of the Tdap vaccine which covers tetanus, diphtheria and pertussis (whooping cough) is now recommended to all adults. If you’ve already had a Tdap shot, you should return to getting a tetanus-diphtheria (Td) booster shot every 10 years. Most private health and Medicare Part D plans cover these vaccinations, but if you have to pay, they cost between $20 and $100.

MMR (measles, mumps and rubella): Anyone born during or after 1957 that is unsure about their immunization history should receive the MMR shot. A blood test can tell whether someone has had any of these diseases or has received the MMR vaccine, but a test costs approximately $100. If you’re unsure about your immunity, getting a booster shot is more cost-effective (around $50 and is usually covered by insurance) and isn’t harmful, even if you’re already immune.

Hepatitis A: This is a two-dose series of shots recommended to adults age 50 and older that have chronic liver disease, a clotting-factor disorder, have same-sex male partners, illicit injectable drug use, or who have close contact with a hepatitis A-infected individual or who travel to areas with a high incidence of hepatitis A. These shots cost anywhere from $60 to $300, but are covered by most health and Medicare prescription drug plans.

Hepatitis B: This three-dose series is recommended to adults 50 and older who are on dialysis, have renal disease or liver disease, are sexually active with more than one partner, have a sexually transmitted disease or HIV. These vaccinations are covered under Medicare Part B.

Meningitis: Adults 55 and younger who have never been vaccinated, have had their spleen removed, have certain blood deficiencies or plan to travel to parts of the world where meningitis is common, should receive the meningococcal conjugate vaccine. Adults 56 and older should receive the polysaccharide vaccine. Covered by most health and Medicare Part D plans, this shot will cost around $100 to $150 if you have to pay out-of-pocket.

To help you get a handle on which vaccines are appropriate for you, take the CDC “What Vaccines Do You Need?” quiz at www2.cdc.gov/nip/adultimmsched. Also, talk to your doctor during your next visit.

 

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