Pneumonia is an infection that targets the lungs and can cause fever, difficulty breathing, and other symptoms. Pneumonia shots help prevent pneumonia.

Eligibility

Medicare Part B covers pneumonia vaccines. Speak with your doctor to learn which pneumonia vaccines you need based on your age and any vaccines you already received.

Costs

If you qualify, Original Medicare covers pneumonia shots at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover pneumonia shots without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.

During the course of your pneumonia shot, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.