People With Medicare
Pneumococcal (Pneumonia) Shots
What it is:
Pneumococcal disease can make you very sick or even kill you. It happens when bacteria (called pneumococcus) attack different parts of the body. It can invade the lungs and cause pneumonia. It can invade the bloodstream and cause bacteremia. Or it can invade the covering of the brain and cause meningitis. It can also cause middle ear and sinus infections.
You can get this shot on the same day that you get the flu shot. But you can get it at any time of year. One shot may be all you ever need, but you should discuss this with your doctor.
Why it is important:
Pneumococcal pneumonia kills thousands of older people in the United States each year. The shot may protect you.
Who is covered:
Anyone with Medicare can get their pneumococcal shot covered by Medicare.
How often is it covered:
The pneumococcal shot is generally covered once in your lifetime (although some people may need it more often). Ask your doctor about whether you might need this shot and how you can get it.
What you pay:
- If you have Original Medicare and see a doctor who "accepts assignment," you pay nothing for this shot. Doctors who accept assignment agree to accept the amount that Medicare will pay for a visit or service (called the Medicare-approved amount) as payment in full.
If you are in a Medicare Advantage plan, the plan cannot charge you for this shot as long as you see an "in-network" provider, meaning a doctor who has an agreement to treat people who belong to the plan. If you use a provider outside your plan's network, it may cost you money.
Learn more about Pneumococcal Shots on Medicare.gov
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