Immunizations – Not Just for Kids
August is National Immunization Awareness Month (NIAM). This annual observance provides an opportunity to raise awareness and highlight the importance of immunizations across the lifespan.
Vaccines are an important step in protecting against serious and sometimes deadly diseases. Even healthy adults can become seriously ill and can pass certain illnesses on to others. Immunizations are especially important for older adults and for adults with chronic conditions such as asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, or heart disease.
The Centers for Disease Control and Prevention (CDC) is asking all health care professionals – whether you provide immunization services or not – to routinely assess the vaccine needs of your patients and make a strong recommendation for needed vaccinations. Medicare provides coverage for vaccines under Medicare Part B and the Medicare prescription drug plans (Part D).
Medicare Part B covers the following vaccines for beneficiaries that meet certain eligibility requirements:
- Hepatitis B vaccine (for patients at high or intermediate risk);
- Influenza virus vaccine;
- Pneumococcal vaccine; and
- Vaccines directly related to the treatment of an injury or direct exposure to a disease or condition.
Medicare Part D covers vaccines not covered by Part B, as long as the vaccine is reasonable and necessary to prevent illness.
- Part D plans identify covered drugs and vaccines through formularies.
- A new preventive vaccine may not specifically appear in the formulary, but the plan may still cover the vaccine. Contact your patient’s plan to find out about coverage.
NOTE: CMS requires that Part D plan formularies must include all commercially available vaccines (except those covered by Part B). You can find plan contact information on the Medicare.gov website, or call 1-800-MEDICARE.
For More Information
- Medicare Learning Network® “Preventive Services (PDF)” Educational Tool.
- Medicare Learning Network “Medicare Part B Immunization Billing (PDF)” Educational Tool.
- Medicare Learning Network “Vaccine and Vaccine Administration Payments Under Medicare Part D (PDF)” Fact Sheet.
- Medicare Learning Network “Mass Immunizers and Roster Billing: Simplified Billing for Influenza Virus and Pneumococcal Vaccinations (PDF)” Fact Sheet.
- Advisory Committee on Immunization Practices
- CDC NIAM Website
- National Public Health Information Coalition NIAM Toolkit
- Check with your state or local health department to see if they have additional immunization resources you can use during NIAM or plans to celebrate the month.