Dear Marci,

I want to get my seasonal flu shot, but I'm afraid Medicare won't cover it. Does Medicare cover the flu shot?

Richard

Dear Richard,

Yes. Medicare Part B, the part of Medicare that covers most outpatient services, covers a flu shot once every flu season. The flu season typically runs from November until April. This means that Medicare may cover a flu shot twice in one calendar year. For example, if you get a shot in January 2013 for the 2012-2013 flu season, you could get another shot in November 2013 for the 2013-2014 flu season.

The flu shot is covered by Medicare Part B as a preventive service. This means that you will not have to meet your Part B deductible in order for Medicare to cover your flu shot. This is true, whether you get your Medicare benefits through Original Medicare or a Medicare Advantage plan. Remember, a deductible is the amount you pay out of your own pocket towards covered services, before your health insurance begins to cover the cost of your care.

If you have Original Medicare, the traditional Medicare program administered by the federal government, you can get your flu shot from any health care provider (e.g. doctor or pharmacy), as long as the provider accepts Medicare. Keep in mind, however, that you will pay nothing for a seasonal flu shot if you go to a provider that accepts Medicare and takes assignment. A provider that takes assignment accepts the Medicare-approved amount for health care services as full payment. If you see a provider who does not take assignment, you may pay a little more for your flu shot. You can call 800-MEDICARE or contact your health care provider to learn whether your health care provider accepts Medicare and takes assignment.

If you have a Medicare Advantage plan, also known as a Medicare private health plan, your plan should pay for the entire cost of the flu shot as long as you follow the plan's rules. For example, plans may agree to pay for the entire cost of your flu shot, as long as you get your flu shot from doctors or pharmacies that are within the plan's network.

-Marci

Health Tip

According to a BBC News article, a New England Journal of Medicine study found that people who eat nuts regularly appear to live longer. The study followed about 120,000 people for 30 years. Researchers found that subjects who ate nuts once a week were 11 percent less likely to have died during the study than those who did not eat nuts. The article did mention, however, that those who ate nuts may have also led healthier lifestyles.

Researchers suggest that eating nuts lower cholesterol, inflammation and insulin resistance.

For free personal counseling on benefits, rights and options for people on Medicare and their families, call Pat at the State Health Insurance Assistance Program (SHIP) located at the Agency on Aging for Northeastern Vermont at 748-5182 or 1-800-642-5119.

Dear Marci is a biweekly column published by the Medicare Right Center and is made available to local residents via the Agency on Aging.

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