19 Dec Inflation Reduction Act & Vaccines
How is Medicare Part D Coverage of Vaccines Changing?
Why does a bill called the Inflation Reduction Act impact the cancer community, and how does that relate to Medicare Part D coverage of vaccines? Keep reading to find out!
What is the Inflation Reduction Act of 2022?
In August 2022, President Biden signed the Inflation Reduction Act (IRA) of 2022 into law. The IRA is a federal law that covers a number of different topics, including improving Medicare coverage of vaccines.
How does the Act apply to vaccines?
Under the IRA, most adult vaccines covered under Medicare Part D will now be free — meaning that you don’t pay a deductible, coinsurance, or co-payment.
Which vaccines are covered under Medicare Part D?
Under Part D, shingles, tetanus, diphtheria, and whooping cough (Tdap) vaccines will be available now at no cost.
If you have Medicare Part B (either through Original Medicare or a Medicare Advantage Plan), you already have 100% coverage for flu, pneumonia, hepatitis B and COVID-19 vaccines.
The IRA expands the list of vaccines that are fully covered under Part D.
According to the CMS, drug plans cover all commercially available vaccines when they’re reasonable and necessary to prevent illness (except those already covered by Part B).
Even if a drug plan’s formulary doesn’t list all Part D vaccines, it must provide access when a physician prescribes a Part D vaccine to prevent a patient’s illness.
You may read the Vaccine-Specific ACIP Recommendations list here.
Who is eligible for vaccines under the IRA?
Medicare beneficiaries with Part D coverage and/or those with Medicare Part B (either through Original Medicare or a Medicare Advantage Plan) will benefit from the IRA’s vaccine coverage.
Where can I find more information?
For more information, read the IRA Vaccine Coverage Fact Sheet.
For more information about health insurance, see our Health Insurance Materials & Resources.
About Triage Cancer
Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through events, materials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.
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