Posted On May 8th, 2023
Medicare’s coverage of vaccinations recommended for adults is split between its Part B medical benefits and Part D prescription drug benefits, although coverage of vaccinations for two highly-prevalent infectious respiratory diseases, influenza, and COVID-19, are both covered under Part B medical benefits. The split in coverage is ripe for reassessment. For example, Medicare coverage of new and oncoming vaccinations for the respiratory syncytial virus (RSV) will default into Part D coverage, which will reduce opportunities to promote, administer, and reimburse vaccinations for infectious respiratory disease on a unified basis. Other factors, including increasing enrollments in Medicare Advantage-Prescription Drug Plans, also compel a new look at how Medicare’s coverage of all recommended vaccinations could be more effective.
NEHI brought together key stakeholders in late 2022 and early 2023 to assess Medicare vaccination coverage. “Medicare Vaccination Coverage After the Inflation Reduction Act” summarizes the findings of NEHI staff on the future of Medicare vaccination policy.
AARP Public Policy Institute
Alliance of Community Health Plans
Adult Vaccine Access Coalition
Adult Vaccine Access
AHIP - America’s Health Insurance Plans
American Academy of Family Practice
Better Medicare Alliance
CVS Health
Epstein Becker & Green
Gerontological Society of America
GSK
HealthNexus
Johnson & Johnson
Kaiser Permanente
LeadingAge
Moderna
National Association of Chain Drug Stores
National Community Pharmacists Association
National Council of Prescription Drug Plans
STCHealth
TransactRX
VaxCare
Walgreens