Medicare's Coverage of Pneumococcal Vaccinations

Published 05/08/2018

Medicare covers pneumococcal vaccinations, which help prevent pneumococcal diseases such as pneumonia. Medicare covers an initial pneumococcal shot if you have never received the vaccination under Medicare Part B, and it covers a second shot when one year or more has passed since the initial injection. The second shot is slightly different than the first because multiple doses of the same vaccine are not generally recommended. 

If you chose to have these shots, you don’t have to show proof (such as an immunization record) of previous vaccinations. Simply tell your doctor or provider when you recall having your last pneumococcal shot. With electronic health records, doctors and providers are presumed to have access to much of a patient’s history.

We encourage you to talk with your doctor about the pneumococcal vaccines, but you do not need a doctor’s order to receive the shots. Instead, you can request the vaccination, and a doctor doesn't need to supervise the injection. The shots are free if your provider accepts Medicare assignment. (To 'accept assignment' means your doctor, health care provider or supplier has a signed agreement to be paid directly by Medicare and to accept the Medicare-approved amount as full payment.)

If you have questions about this coverage, please call our Beneficiary Contact Center at 800-833-4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET. For the hearing impaired, call TTY/TDD at 877-566-3572. This line is for the hearing impaired with the appropriate dial-up service and is available during the same hours Customer Service Representatives are available.

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