Does Medicare Cover Pneumonia Shots (Prevnar 13)?

Christian Worstell
In this article...
  • Medicare covers two pneumonia shots, including Prevnar 13. This article discusses how enrollees can get the total cost of this vaccine covered by Medicare.

Medicare beneficiaries seeking to maintain their health through safe and effective vaccines may wonder which vaccines are covered by their plan. Medicare Part B does cover two pneumonia vaccinations, including Prevnar 13, as routine preventative care. Coverage for pneumonia vaccines is also available through Medicare Part C (Medicare Advantage) plans

Prevnar 13 and Pneumovax 23 

There are two pneumonia vaccines available: Prevnar 13 and Pneumovax 23. Each shot protects against different strains of bacteria that can cause pneumonia and related complications like meningitis. 

The Prevnar 13 vaccine protects against 13 Streptococcus pneumoniae strainsDoctors may recommend the Prevnar 13 shot for: 

  • Some older adults
  • People with underlying immune conditions
  • Those who live in long-term care facilities

Although Prevnar 13 isn't necessary for everyone, Medicare does cover the pneumonia shot. Beneficiaries should talk to their doctor about whether to get one or both vaccines. 

Does Medicare Pay for Both Pneumonia Vaccines?

Medicare Part B will pay for both Prevnar 13 and Pneumovax 23. Beneficiaries can get the first vaccine at any time, and the other shot will be covered if given at least one year later. Enrollees should follow their doctor's advice when deciding which vaccine to get first. 

How Much Does the Pneumonia Vaccine Cost? 

Medicare Part B covers the total cost of Prevnar 13, with no copays, as long as the beneficiary gets the vaccine through a provider who accepts Medicare. Enrollees in Medicare Part C plans can also get full coverage for the shots if administered through an in-network provider. Without coverage, the cost of a Prevnar 13 pneumonia shot is about $267. Because pneumonia shots are covered by Medicare Part B, beneficiaries can get vaccinated at no cost even if they don't have a Medicare Part D prescription drug plan

Which Vaccines Does Medicare Cover? 

Medicare Part B covers: 

  • Pneumococcal (pneumonia) shots
  • Hepatitis B shots
  • Influenza (flu shots)
  • The COVID-19 vaccine 

Other vaccines may be covered through Medicare Part D prescription drug plans.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at

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