Medicare coverage for shingles is available. If you are at risk for shingles, talk to your doctor about options.
Having coverage in addition to Medicare can help you manage the cost of your healthcare. Quality health coverage can mean focusing on your health instead of your bank account.
Does Medicare Cover Shingles Vaccines
Part B will cover you when you visit a dermatologist or other doctor to treat shingles. Prescription drug plans usually include shingles medications and the shingles vaccine.
However, because Part D has different deductibles, pharmacy networks, and co-pays, the amount you pay for shingles can vary.
Medicare Part B Coverage for Shingles Treatment
Part B covers doctor visits, and that includes visits to diagnose and treat shingles. Also, Part B will pay 80 percent of the doctor’s bill after you have met your annual deductible ($197 in 2020). You can get additional coverage with a Medicare Supplement plan.
Most Medigap policies cover the 20% that Medicare leaves you responsible for paying. When you have comprehensive coverage, you can get the care you need, when you need it.
If you have a Medicare Advantage plan, your doctor visits will have coverage, but you must see a doctor within your insurance company’s network.
Advantage policies almost always have a co-payment or coinsurance for a doctor’s visit; talk to your plan about your coverage before you go to the doctors.
Prescription Drug Coverage and Shingles Treatment
To get coverage for shingles medications and vaccines, you must have a Part D plan or a prescription plan that is part of a Medicare Advantage plan.
Every prescription plan is a little different, but all of them have a “Formulary,” along with your copay or coinsurance information.
To find out how much a specific shingles drug or the shingles vaccine will cost you, contact your prescription insurance company.
If your policy is with us, contact our Client Service Team, and they will be happy to give you all the information you’ll need about shingles and your coverage.
Most prescription plans also operate with a preferred network of pharmacies. Typically, you will pay less for medication if you use a network pharmacy.
If you use a pharmacy that is out of network, you could be responsible for the full cost. Contact your provider to find the best pharmacy option in your area.
Coverage that includes a prescription drug plan is an essential part of treating and preventing conditions like shingles.
What is Shingles?
Shingles is a painful skin condition caused by the varicella-zoster virus – the same virus that causes chickenpox. If you had chickenpox as a child, your symptoms probably went away within a week or two.
However, the virus stayed in your nerve tissues. In some people, the virus reactivates in the form of shingles. You can’t get shingles unless you have had chickenpox.
Shingles are not dangerous, but it is unattractive and painful. The risk of getting shingles goes up as you age.
If you ever had chickenpox, you probably remember how much it itched. Shingles can itch too, but it is more likely to cause pain.
Here is what to expect, according to the American Academy of Dermatology:
- First, an area of skin on one side of the body will begin burning, itching, tingling, or feeling unusually sensitive. Symptoms may go on for one to three days, and it may be constant or intermittent.
- Next, a rash develops in this same area. The rash may occur with a fever, chills, or headache.
- The rash then turns into clear blisters. These blisters may last two to three weeks, and they are likely to become yellow or bloody before scabbing over.
The blisters are painful. The pain will get better as the blisters heal, but some people continue to have shingles pain for several months.
Medicare coverage for shingles is available. If you need a vaccine or antiviral medication, Medicare has your back.
Antiviral medications such as famciclovir, valacyclovir, and acyclovir can make a shingles episode less painful. Medications can help you avoid serious complications of shingles.
One of the most common complications is postherpetic neuralgia, pain, or numbness in the location of the shingles rash that can last for years.
Antiviral medicines work best within three days of the start of a shingles outbreak. For this reason, it is vital to see a doctor right away if you suspect you have shingles.
Your doctor may prescribe pain relievers, nerve block injections, or corticosteroid injections. Calamine lotion, ice packs, and oatmeal baths can also help relieve the pain and itching.
Shingles itself is not contagious. However, if you have shingles, you can transmit the chickenpox virus to someone who has never had chickenpox or the chickenpox vaccine.
Vaccines for Prevention
Medicare coverage is available for the shingles vaccine. Many seniors use Part B benefits to cover part of the cost for the shot.
A vaccine can reduce your chance of getting shingles, but no vaccine will prevent all shingles cases.
If you have the vaccination and you get shingles anyway, you are more likely to have a milder case, and you are less likely to develop complications.
There are three vaccination options:
- If you have never had chickenpox, the chickenpox (varicella) vaccine can lessen the chances that you will get chickenpox or, later, shingles.
- The newest shingles vaccine, Shingrix, received FDA approval in 2017. The Centers for Disease Control and Prevention recommends Shingrix for healthy people aged 50 and up. It is given in two doses, six months apart.
- The older shingles vaccine, Zostravax, may also be given in some instances.
Get Coverage Now!
To start your quote, give us a call at the number above or fill out our form online by clicking here!
Our Insurance Brokers are here to help you through the enrollment process. Then, the Client Service Team will be available for you during the life of your policy.
We’re ensuring peace of mind when it comes to health coverage.