National Immunization Awareness Month presents a great opportunity to educate seniors and other people with Medicare on the importance of disease control and prevention through immunization and the vaccines covered by Medicare that help prevent disease. Vaccine-preventable disease levels are at or near record lows, yet many adults remain under-immunized, missing opportunities to protect themselves against diseases such as hepatitis B, seasonal influenza, and pneumococcal disease. Vaccines are even more important for people with chronic health conditions. An underlying health condition can make a person more susceptible to contracting a disease or have a more serious outcome if they do contract a disease
Medicare Part B Immunization Benefits:
Medicare provides coverage for seasonal influenza, pneumococcal, and hepatitis B vaccines and their administration for qualified beneficiaries as preventive immunizations.
Seasonal Influenza Immunization: Medicare covers one seasonal influenza virus vaccine per influenza season; a beneficiary could get more than one seasonal influenza virus vaccination in a 12-month period. Medicare may cover additional influenza vaccinations, if medically necessary.
Pneumococcal Immunization: Medicare generally covers pneumococcal vaccination once in a lifetime for all Medicare beneficiaries. Medicare may cover additional vaccinations based on risk or uncertainty of beneficiary pneumococcal vaccination status.
Hepatitis B Immunization: Medicare covers the hepatitis B vaccinations that are reasonable and necessary for the prevention of illness for those individuals who are at high or intermediate risk of contracting hepatitis B virus.
CMS asks healthcare providers who provide care to seniors and others with Medicare to join us during National Immunization Awareness Month to help protect your Medicare patients from vaccine-preventable diseases. This can be done by ensuring their immunizations are up-to-date, educating them on risk factors, and encouraging their use of appropriate Medicare-covered immunizations.
Resources from CMS for Healthcare Professionals:
The Guide to Medicare Preventive Services, Chapter 5
More Information for Healthcare Professionals:
Medicare Immunization Billing Quick Reference Chart
Preventive Immunizations Brochure
Mass Immunizers and Roster Billing Factsheet
CMS Immunizations Web Page
CMS Medicare Learning Network® (MLN) Preventive Services Educational Products Web Page
The CDC Vaccines and Immunizations Web Page
National Immunization Awareness Month 2012 Toolkit
Immunization Action Coalition Website