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Medicare Part D
Prescription Drug Coverage 2027
Medicare Part D Vaccines 2027: Which Shots Are $0 and Which Part Pays
Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated November 1, 2026
For Medicare Part D vaccines in 2027, adult vaccines recommended by the CDC’s advisory committee cost $0, with no deductible, including shingles (Shingrix), RSV and Tdap. Flu, COVID-19, pneumococcal and most hepatitis B shots are paid by Part B instead, also at no cost to you.
2027 by the Numbers
$0
your cost for ACIP-recommended adult vaccines under Part D (CMS)
4
vaccine groups Part B pays: flu, COVID-19, pneumococcal, hepatitis B (CMS)
323
2027 standalone Part D plan filings that must follow the $0 rule (our count of CMS 2027 plan filings)
Medicare splits vaccines between two parts of the program. Part B, the medical side, pays for a short list named in Medicare law. Part D, the drug side, pays for most other commercially available vaccines, such as Shingrix for shingles and the RSV shot.
The split matters less for your wallet than it used to, because both sides now charge $0 for the main adult vaccines. It still matters for where you go and which card you show. The rules below apply to standalone drug plans and to Medicare Advantage plans with drug coverage. For the rest of the year’s changes, see the Medicare Part D plans 2027 hub.
Key Takeaways
- Shingrix, RSV, Tdap and other ACIP-recommended adult vaccines cost $0 under Part D, and the deductible does not apply.
- Part B covers flu, COVID-19, pneumococcal and hepatitis B shots for people at intermediate or high risk, with no copay.
- A tetanus shot after an injury is a Part B treatment service; a routine Tdap booster is a Part D vaccine.
- Getting a Part D vaccine at an in-network pharmacy is usually simplest; a doctor’s office may bill differently.
- Federal vaccine advisory decisions changed in 2025 and parts were paused by a court in 2026, so check current guidance before your appointment.
Part B or Part D: A Shot-by-Shot Map
| Vaccine | Paid by | Your cost in 2027 | Notes |
|---|---|---|---|
| Flu (seasonal) | Part B | $0 | Once per flu season |
| COVID-19 | Part B | $0 | Covered by Part B, not your drug plan |
| Pneumococcal (pneumonia) | Part B | $0 | Doses per CDC schedule |
| Hepatitis B | Part B | $0 | For intermediate or high risk, including an unknown or incomplete shot history |
| Shingles (Shingrix) | Part D | $0 | Two-dose series |
| RSV | Part D | $0 | Adults 75+ and adults 50-74 at higher risk |
| Tdap or Td (routine) | Part D | $0 | Booster not tied to an injury |
| Hepatitis A (routine) | Part D | $0 if ACIP-recommended for you | Part B only for treatment after exposure |
| Travel or non-recommended vaccines | Part D | May have a copay | Depends on the plan’s formulary |
Based on the CMS Medicare Part D Vaccines fact sheet (MLN908764, July 2026) and Medicare.gov coverage pages.
How the $0 Rule Works in 2027
Under Part D, an ACIP-recommended adult vaccine
✔
Costs $0 coinsurance or copay
✔
Is not subject to the $700 deductible
✔
Stays $0 even from an out-of-network provider, per CMS
✔
Includes the cost of giving the shot, since plans build the administration fee into the vaccine’s negotiated price
A vaccine that is not on the ACIP adult list, such as some travel vaccines, can still be covered by a Part D plan, but the plan may charge its normal tier cost. Not all plans cover every vaccine of that kind; check the 2027 formulary for your plan.
Do $0 Vaccines Count Toward the $2,400 Cap?
| Scenario in 2027 | Paid by you | Added to your $2,400 cap |
|---|---|---|
| Two Shingrix doses at a network pharmacy | $0 | $0 |
| One RSV shot at a network pharmacy | $0 | $0 |
| Travel vaccine with a $50 tier copay (example) | $50 | $50 |
| Out-of-network shot, fee paid up front, later repaid | $0 after repayment | $0 |
Our worked examples from the CMS 2027 parameters. Only amounts you or certain programs pay count toward the cap, so a $0 vaccine neither uses up the cap nor moves you through the deductible. The $50 copay is an illustration, not a quoted plan price.
Budget point: because recommended vaccines skip the deductible, getting Shingrix in January does not require meeting the $700 deductible first.
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Pharmacy Counter or Doctor's Office
In-network pharmacy
✔
Pharmacist gives the shot, where state law allows
✔
Pharmacy bills your Part D plan directly
✔
Usually nothing to pay at the counter
Doctor’s office
✔
Part B shots are billed to Medicare as usual
✔
For Part D shots, the office counts as out of network for giving the shot
✔
You may pay the fee up front and ask your plan to repay you
If your doctor stocks a Part D vaccine, ask before the visit whether the office can bill your drug plan. Some offices send patients to a network pharmacy instead, which avoids the reimbursement step.
The Tetanus Split: Injury Versus Routine Booster
Same shot, different part: CMS lists tetanus given to treat an injury or exposure, such as a deep cut, as a Part B service. A routine Td or Tdap booster every 10 years falls under Part D. Rabies and hepatitis A shots given after an exposure work the same way and go to Part B.
This matters when a bill arrives. An urgent care visit for a cut is billed to Part B, and the shot is part of that care. A booster at a pharmacy is billed to the drug plan at $0.
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Shingles and RSV: Who Qualifies
Shingrix
Two doses, given 2 to 6 months apart; adults 50 and older, plus some younger adults with weakened immune systems
RSV, age 75+
Recommended for adults in this age group
RSV, ages 50-74
Recommended for adults with certain health conditions that raise the risk of severe illness
Medicare.gov lists the 50 to 74 high-risk group for RSV, an expansion from the earlier 60-and-up guidance. The RSV shot is currently a one-time dose, not a yearly one.
Federal Vaccine Policy Changes and 2027 Coverage
1
June 2025. HHS replaced the members of the Advisory Committee on Immunization Practices (ACIP), the panel whose recommendations set Part D’s $0 rule.
2
September and October 2025. The new panel moved COVID-19 vaccination to individual, shared clinical decision-making, and the CDC adopted the change.
3
CMS position. CMS has said Part D must still cover vaccines with a shared clinical decision-making label at $0.
4
March 2026. A federal judge temporarily stayed a set of HHS and ACIP decisions made since May 2025 in AAP v. Kennedy. The case is ongoing.
Hedge for 2027: Part B coverage of flu, COVID-19, pneumococcal and hepatitis B shots is written into Medicare law rather than set by ACIP votes. For Part D shots, recommendations could shift again during 2027, so confirm with your plan or pharmacist before a visit. Premium details for the year are in the Part D premium 2027 guide.
The Bottom Line
The Bottom Line
In 2027, recommended adult vaccines cost nothing whether Part B or Part D pays. Shingrix, RSV and routine Tdap go through your drug plan with no deductible, while flu, COVID-19, pneumococcal and most hepatitis B shots go through Part B. A network pharmacy is usually the easiest place to get a Part D shot.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048) to get information on all of your options.
Frequently Asked Questions
➤ Is Shingrix free under Medicare Part D in 2027?
Yes, for adults it is recommended for. Both doses are $0 with no deductible under standalone Part D plans and Medicare Advantage plans with drug coverage.
➤ Does Part D cover the flu shot?
No. Medicare Part B covers the seasonal flu shot at no cost, so show your red, white and blue Medicare card or your Medicare Advantage card.
➤ Which part of Medicare pays for the COVID-19 vaccine?
Part B. You pay nothing when the provider accepts Medicare.
➤ Is the RSV vaccine covered for people under 60?
Medicare.gov lists adults ages 50 to 74 with certain health conditions, plus everyone 75 and older, as the groups at high risk. Ask your doctor whether you fit.
➤ Do I have to meet my deductible before a Part D vaccine?
No. ACIP-recommended adult vaccines skip the Part D deductible and have no copay.
➤ Can I get a Part D vaccine at my doctor’s office?
Yes, but the office may not be able to bill your drug plan. You may pay up front and ask your plan to repay you, so a network pharmacy is often simpler.
➤ Does a tetanus shot after a cut go through Part D?
No. A tetanus shot to treat an injury is billed to Part B. A routine Tdap or Td booster goes through Part D.
➤ Could vaccine recommendations change during 2027?
They could. Federal advisory decisions changed in 2025 and a court paused some of them in 2026. CMS guidance ties Part D’s $0 rule to ACIP recommendations.
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