Does Medicare Cover Shingrix and RSV Vaccines in 2026?

Direct Answer: What Medicare Covers for Shingrix and RSV Vaccines in 2026

Yes. Medicare covers both the Shingrix shingles vaccine and the RSV vaccine through Medicare Part D, at $0 cost-sharing since January 1, 2023 under the Inflation Reduction Act. Original Medicare Part A and Part B do not cover either vaccine directly; both fall under the Part D pharmacy benefit because they are ACIP-recommended adult vaccines, not part of the small set Part B covers. Beneficiaries without Part D or Medicare Advantage drug coverage pay full price until enrolled.

Why Shingrix and RSV Fall Under Part D, Not Part B

Medicare Part B covers only four vaccines outright: the flu shot, the pneumococcal vaccine, the COVID-19 vaccine, and the Hepatitis B vaccine for people at high or intermediate risk. Neither Shingrix nor the RSV vaccine is on that list because Part B's vaccine authority is limited to a small statutory set tied to seasonal illness and infection risk, not the broader adult immunization schedule. Every other adult vaccine recommended by the CDC's Advisory Committee on Immunization Practices, including Shingrix, RSV, and Tdap, is covered under Medicare Part D instead.

The Inflation Reduction Act, signed August 16, 2022, closed the cost gap that used to make Part D vaccines expensive. Before 2023, a Part D enrollee could pay full deductible plus coinsurance on a $200 Shingrix dose or a $300 RSV dose. Since January 1, 2023, Part D plans and Medicare Advantage drug plans cannot apply a deductible, copay, or coinsurance to any ACIP-recommended adult vaccine, so Shingrix and the RSV vaccine are $0 at an in-network pharmacy or provider in 2026.

RSV Vaccine Eligibility: Who ACIP Recommends It For in 2026

Three RSV vaccines are licensed in the United States: Arexvy (GSK), Abrysvo (Pfizer), and mResvia (Moderna, an mRNA vaccine). The CDC's Advisory Committee on Immunization Practices routinely recommends a single dose of any of the three for all adults 75 and older. For adults 50 to 74, ACIP recommends a single dose only for those at increased risk of severe RSV, meaning chronic heart, lung, or kidney disease, diabetes, obesity, an immunocompromising condition, frailty, or residence in a nursing home or other long-term care facility. ACIP lowered the risk-based age threshold from 60 to 50 in 2025, so adults as young as 50 with a qualifying condition can now get the vaccine covered.

As of 2026, ACIP has not recommended a second RSV dose or a booster schedule. The vaccine is currently a one-time shot, and the committee is waiting for more data on how long protection from a single dose lasts before issuing revaccination guidance. Anyone unsure whether they qualify under the 50-to-74 risk category should ask their doctor, since Medicare Part D plans generally rely on the prescriber's or pharmacist's clinical judgment rather than requiring separate proof of a diagnosis at the counter.

Shingrix Eligibility: Who Should Get the Shingles Vaccine

Shingrix, the only shingles vaccine sold in the United States since Zostavax was discontinued in November 2020, is recommended by ACIP for two groups. Adults 50 and older should get two doses two to six months apart regardless of whether they remember having chickenpox or a prior shingles episode. Adults 19 and older who are or will become immunocompromised due to disease or therapy should get two doses one to two months apart, on an accelerated schedule because their infection risk is higher. Unlike RSV, Shingrix already has an established two-dose schedule, and Medicare Part D covers both doses at $0 in 2026.

What Medicare Advantage Covers for Both Vaccines in 2026

Medicare Advantage plans that include drug coverage, commonly called MA-PD plans, follow the same $0 rule as standalone Part D plans for both Shingrix and the RSV vaccine. Roughly 96 percent of Medicare Advantage enrollees are in an MA-PD plan in 2026, so most Medicare Advantage members already have both vaccines covered at no cost. A small number of Medicare Advantage plans do not include drug coverage, usually because the enrollee has other creditable drug coverage, and those members need a standalone Part D plan to get either vaccine covered.

Network matters more than plan type. Medicare Advantage plans typically use narrower pharmacy and provider networks than standalone Part D plans, so an MA-PD enrollee should confirm that the pharmacy or clinic administering either shot is in-network before the appointment, since an out-of-network administration can trigger a bill even though the vaccine itself carries no required cost-sharing. Many pharmacies can administer Shingrix and the RSV vaccine during the same visit, along with a flu or COVID-19 shot, as long as the plan's network rules are followed.

Cost Without Part D Coverage in 2026

Without Part D or Medicare Advantage drug coverage, Shingrix costs $150 to $250 per dose at most pharmacies in 2026, and the two-dose series runs $300 to $500 total. The RSV vaccine runs higher: Arexvy, Abrysvo, and mResvia each cost roughly $300 to $600 per dose in cash, since only one dose is currently recommended. GSK, Pfizer, and Moderna each offer a patient assistance program for uninsured or underinsured patients who meet income guidelines, and pharmacy discount programs like GoodRx can lower the cash price on both vaccines.

Fewer than 10 percent of Medicare beneficiaries in 2026 actually face full-price vaccine costs, since nearly every Medicare beneficiary carries either a standalone Part D plan or an MA-PD plan; the main exceptions are beneficiaries with other creditable drug coverage such as employer retiree benefits or TRICARE for Life, both of which also cover ACIP-recommended vaccines at low or no cost.

How to Get Both Vaccines Covered at $0 Through Medicare

Three steps get most Medicare beneficiaries $0 Shingrix and RSV shots. First, confirm you have a Part D plan or an MA-PD plan by checking your member ID card for an Rx symbol or logging into your plan portal. Second, find an in-network pharmacy or provider using your plan's pharmacy locator or by calling the number on your card, since either vaccine administered out-of-network can generate a bill even under the IRA's $0 rule. Third, bring your Medicare Part D or Medicare Advantage card, not just your red, white, and blue Medicare card, since both vaccines are billed through the drug benefit, not the medical benefit.

If you do not yet have a Part D or Medicare Advantage plan, you can enroll during the Annual Enrollment Period, October 15 through December 7, 2026, for coverage starting January 1, 2027, or during a Special Enrollment Period if you qualify, such as recently becoming eligible for Medicare or losing other creditable drug coverage. Medicare Advantage enrollees can also switch plans during the Medicare Advantage Open Enrollment Period, January 1 through March 31, 2026, if their current MA-PD plan's network does not include a convenient pharmacy or clinic.

Vaccine Coverage Before Medicare: ACA-Compliant and Employer Plans

Adults under 65 who are not yet on Medicare and qualify for either vaccine, most commonly the immunocompromised population Shingrix covers starting at age 19 or the risk-based RSV group starting at age 50, are generally protected too. ACA-compliant individual and employer plans must cover ACIP-recommended adult vaccines, including Shingrix and the RSV vaccine, as a no-cost preventive service under the essential health benefits preventive and wellness care category, with no copay or deductible when administered in-network. Because vaccination is preventive care, it is not subject to preexisting condition exclusions or medical underwriting under ACA-compliant coverage.

The main exception is grandfathered health plans, meaning plans that existed before the ACA passed in 2010 and have not changed significantly since, which are not required to follow the ACA's no-cost preventive services mandate. Anyone unsure whether their employer plan is ACA-compliant or grandfathered should ask their HR benefits administrator or call the number on the back of their insurance card before assuming a $0 cost.

Does Original Medicare Part B cover Shingrix or the RSV vaccine?

No. Medicare Part B covers only four vaccines directly: flu, pneumococcal, COVID-19, and Hepatitis B for high-risk patients. Both Shingrix and the RSV vaccine fall under Medicare Part D instead, along with every other adult vaccine recommended by the CDC's Advisory Committee on Immunization Practices. If you have only Part A and Part B with no Part D plan, neither vaccine is covered until you enroll in a Part D or Medicare Advantage drug plan.

Does Medicare Advantage cover Shingrix and the RSV vaccine?

Yes, if your plan includes drug coverage (an MA-PD plan). About 96 percent of Medicare Advantage enrollees are in an MA-PD plan in 2026, and those plans must follow the same $0 cost-sharing rule for ACIP-recommended vaccines as standalone Part D plans. Confirm your pharmacy or clinic is in-network before your appointment to avoid a separate bill.

How much do Shingrix and the RSV vaccine cost without Part D coverage in 2026?

Shingrix costs $150 to $250 per dose in 2026, or $300 to $500 for the two-dose series, without Part D or Medicare Advantage drug coverage. The RSV vaccine (Arexvy, Abrysvo, or mResvia) costs roughly $300 to $600 for its single dose. Pharmacy discount programs like GoodRx and manufacturer patient assistance programs can lower these cash prices for eligible low-income, uninsured patients.

Who qualifies for the RSV vaccine under Medicare in 2026?

Adults 75 and older qualify routinely. Adults 50 to 74 qualify if they have an increased risk of severe RSV, meaning chronic heart, lung, or kidney disease, diabetes, obesity, an immunocompromising condition, frailty, or residence in a long-term care facility. ACIP lowered the risk-based age threshold from 60 to 50 in 2025, expanding who can get the vaccine covered at $0.

Who should get the Shingrix vaccine according to the CDC?

The CDC's Advisory Committee on Immunization Practices recommends two doses of Shingrix for adults 50 and older, given two to six months apart, regardless of prior chickenpox or shingles history. Adults 19 and older who are or will become immunocompromised should get two doses one to two months apart. Roughly 1 in 3 Americans develop shingles in their lifetime.

Do I need a booster or second dose of the RSV vaccine?

Not currently. As of 2026, ACIP recommends the RSV vaccine as a single dose and has not issued revaccination guidance. The committee is waiting for more data on how long protection from one dose lasts and how effective a second dose would be before recommending a booster schedule, unlike Shingrix, which already requires two doses.

What is the difference between Arexvy, Abrysvo, and mResvia?

All three are FDA-approved RSV vaccines covered the same way under Medicare Part D: Arexvy is made by GSK, Abrysvo by Pfizer, and mResvia by Moderna using mRNA technology, the same platform used in Moderna's COVID-19 vaccine. ACIP does not prefer one brand over another for eligible adults; any of the three satisfies the recommendation, and Medicare Part D plans cover all three at $0 cost-sharing.

Will my Medicare Part D plan charge a copay for Shingrix or the RSV vaccine?

No. Since January 1, 2023, the Inflation Reduction Act requires all Medicare Part D plans and Medicare Advantage drug plans to cover ACIP-recommended adult vaccines, including Shingrix and RSV, with no deductible, no copay, and no coinsurance. If a pharmacy tries to charge you, ask them to rebill using your Part D benefit rather than a cash transaction.