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Is Shingrix free for seniors?

Shingrix is the only shingles vaccine, and it’s typically free with health insurance
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By | Jul. 8, 2024 Medically reviewed by Samantha Marr, DNP, APN, AGPCNP-BC, CCRN
A vaccine and vial: Is Shingrix free for seniors?

Key takeaways

  • Shingrix is a vaccine for shingles, a viral disease common in adults ages 65 and older. 

  • Medicare Part D plans are required to cover Shingrix for their beneficiaries, and many private insurance plans cover it as well. That means most adults over 65 can get it for free. 

  • Without insurance coverage or discounts, both doses of the shingles vaccine can cost nearly $600.

  • Eligible patients can get the shingles vaccine for free from their healthcare provider or pharmacy. Use the Shingrix website or SingleCare to find participating locations.

In this article:

The Centers for Disease Control and Prevention (CDC) estimates that 1 million Americans get shingles every year, and the National Institute on Aging says about half of those cases are in adults ages 60 or older. Shingles (herpes zoster) are caused by the varicella-zoster virus, which also causes chickenpox. Shingles can cause a painful rash, blisters, and post-herpetic neuralgia (PHN). 

Luckily, for older adults, especially those who have weakened immune systems, there is a safe, easy, and effective way to prevent shingles. Shingrix is a vaccine that’s over 90% effective in preventing shingles in adults over 50 years old, according to its manufacturer, GSK. Read on for all the details on getting the shingles vaccine at no cost. 

Are shingles vaccines free?

Yes, for most people the shingles vaccine is free. Most Medicare Part D plans will cover it because they are legally required to. The Affordable Care Act and the Inflation Reduction Act require all Medicare prescription drug plans to cover every vaccine recommended by the Advisory Committee on Immunization Practices (ACIP)—and that includes Shingrix. 

However, not every plan will pay for it upfront. Some plans may require you to pay and then submit a request for reimbursement. Either way, Medicare Part D beneficiaries won’t end up paying anything out of pocket, including copays. “For those with Medicare, it’s worth noting that Shingrix is not covered by Medicare Part B, which typically covers vaccines,” says Soma Mandal, MD, a board-certified internist at Summit Health. Instead, it’s covered under Medicare Part D, the prescription drug plan. The coverage and cost under Part D can vary widely, and some people may still have out-of-pocket costs.”

If you have Medicare Part A or Part B without an add-on Part D plan, you might not receive coverage. Medicare Advantage plans (Part C), on the other hand, often include Part D. Medicaid usually covers Shingrix, but each state has its own policies, so coverage may vary.

Even if you don’t have Medicare Part D or Medicaid, you still might be able to get Shingrix for free. Private insurance plans will cover ACIP-recommended vaccines, such as Shingrix, according to Daniel Kim, DO, a board-certified family physician with the Medical Offices of Manhattan and contributor to LabFinder.com. According to the Shingrix website, 96% of people with private health insurance plans won’t pay a cent. But it ultimately depends on your specific plan. Some may still have copays, coinsurance, or other cost-sharing expenses. 

How old do you have to be to get the shingles vaccine for free?

To be eligible for Medicare coverage and get the shingles vaccine for free, you must be 65 years old. However, people younger than 65 years old with private healthcare plans can potentially get it paid for too. If your insurance plan includes the shingles vaccine in its formulary, you may receive coverage.

How much is Shingrix without insurance?

Since not everyone has Medicare or private insurance, some people might end up paying out of pocket for Shingrix. In those cases, the average out-of-pocket cost for each dose of Shingrix is $275.88. There are two separate doses, so that cost would add up to $551.76. 

The good news is that insurance isn’t the only way to save. For example, SingleCare coupons can drop the price to $216 per dose. Plus, Shingrix’s manufacturer has a patient assistance program called GSKForYou that can help—as long as you meet certain eligibility requirements. 

Where to get the shingles vaccine for free

“You can get the vaccine at most commercial pharmacies or doctors’ offices,” Dr. Kim says. Just make sure the location is in-network and can bill Medicare Part D or your private insurance. Dr. Mandal often recommends that patients get the vaccine at his office, since the shot may cause some discomfort. 

However, there are other places to get the vaccine too. “The Shingrix vaccine can also be received at community health clinics, local health departments, and workplace health clinics,” Dr. Mandal says. The vaccine’s website even has a shingles vaccine locator tool, and pharmacy chains have additional information on how to get it. You can also use the SingleCare website to find participating pharmacies, along with coupons if your insurance doesn’t cover Shingrix. 

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