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Vaccination is a safe and effective way of protecting people against harmful diseases and infections. There are many different vaccines available to protect you and to help you stay healthy. Vaccines are covered under either Medicare Part B (your medical
benefits) or Medicare Part D (your prescription drug benefits) services.
Below are examples of vaccines that are covered differently:
You can view the full list of covered Part D vaccines in our drug list.
There is no copay for the flu, pneumococcal and hepatitis B vaccines.
When you get a Part D vaccine, what you pay depends on who gives you the vaccine.
If you get a Part D vaccine at an in-network pharmacy, your copay for each injection is:
For your convenience, we recommend this option when getting a Part D vaccine.
If you get a Part D vaccine at your doctor’s office, you must pay for:
After you pay at your doctor’s office, then submit a Part D prescription reimbursement claim for Sharp Health Plan to pay our share of the cost. You’ll get a refund for the approved amount less the normal copay for the vaccine (including administration).
The Part D prescription claim form and other forms are available here for download.
We want to highlight three vaccines that are important for keeping you healthy. Talk to your primary care physician or pharmacist to see if these vaccines are right for you.
Sharp Direct Advantage is offered by Sharp Health Plan. Sharp Health Plan is an HMO with a Medicare contract. Enrollment with Sharp Health Plan depends on contract renewal. Read the full disclaimer.