- Pneumococcal vaccines can help prevent some types of pneumonia infection.
- Recent CDC guidelines suggest that people 65 and older should get the vaccine.
- Medicare Part B covers 100% of both types of pneumonia vaccines available.
- Medicare Part C plans must also cover both pneumonia vaccines, but network rules may apply.
Pneumonia is a common infection involving one or both lungs. Inflammation, pus, and fluid can build-up in the lungs, making it hard to breathe. According to the Centers for Disease Control and Prevention (CDC),
Pneumococcal vaccines can prevent common bacterial infections fromStreptococcus pneumoniae. There are two types of pneumonia vaccines available to prevent specific strains of this bacteria.
Fortunately, if you have Medicare Part B or Part C, you will be covered for both kinds of pneumococcal vaccines.
Let’s take a closer look at pneumonia vaccines and how Medicare covers them.
Most preventive vaccines are covered underPart D, the prescription drug part of Medicare. Medicare Part B covers a few specific vaccines, like the two pneumonia vaccines. Medicare Advantage plans, sometimes calledPart C, also cover the pneumonia vaccines, along with other vaccines you may need.
If you are enrolled in original Medicare (Part A and Part B), or a Part C plan, you are automatically eligible for the pneumonia vaccines. Since there are two types of vaccines for pneumonia, you and your doctor will decide if you need one or both vaccines. We’ll get into the details of the two different types a little later.
B部分覆盖范围
Medicare Part B涵盖以下types of vaccines:
- 流感疫苗（流感）
- hepatitis Bvaccine (for those at high risk)
- pneumococcal vaccines (
PCV13 and PPSV23 for bacterialStreptococcus pneumoniae) - 破伤风射击（暴露后治疗）
- rabies shot (treatment after exposure)
Part Btypically pays 80% of covered costs if you visit Medicare-approved providers. However, there are no out-of-pocket costs for vaccines covered by Part B. That means, you’ll pay $0 for the vaccine, as long as the provider accepts Medicare assignment.
Providers who accept assignment agree to Medicare-approved rates, which are usually lower than standard prices. Vaccine providers can be doctors or pharmacists. You can find a Medicare-approvedprovider这里。
Part C coverage
Medicare Part C, or Medicare Advantage plans, are private insurance plans that offer many of the same benefits as original Medicare parts A and B along with some extra options. By law, Medicare Advantage plans are required to offer at least the same amount of coverage as original Medicare, so you will also pay $0 for the pneumonia vaccines through these plans.
NoteMedicare Advantage plans typically have limitations that require you to use service providers that are in the plan’s network. Check your plan’s list of in-network providers before making an appointment to be vaccinated to ensure all costs will be covered.
Medicare Part B covers 100% of the cost of the pneumococcal vaccines with no copayments or other costs. Check that your provider accepts Medicare assignment before the visit to ensure full coverage.
2020年B部分计划的费用包括每月溢价$144.60and a deductible of$198.
There are many different Medicare Advantage plans offered by private insurance companies. Each come with different costs. Review the benefits and costs of each plan with your specific budget and needs in mind to make thebest choice for your situation.
There are currently two types of pneumococcal vaccines that cover different strains of a common type of bacteria (Streptococcus pneumoniae) that can lead to pneumonia. This type of bacteria poses risks for young children but can also be risky for those who are older or have compromised immune systems.
The twovaccinesare:
- pneumococcal conjugate vaccine (PCV13 or Prevnar 13)
- 肺炎球菌多糖疫苗（PPSV23或Pneumovax 23）
According to最近的数据, the CDC Advisory Committee on Immunization Practices recommend that people who are 65 and older should get the Pneumovax 23 shot.
然而，在某些情况下可能需要在某些情况下需要两种疫苗。这些情况可以包括：
- if you live in a nursing home or long-term care facility
- if you live in an area with many unvaccinated children
- if you travel to areas with a large population of unvaccinated children
以下是两个可用疫苗之间的比较：
| PCV13 (Prevnar 13) | PPSv23（Pneumovax 23） |
|---|---|
| 保护13个菌株Streptococcus pneumoniae | Protects against 23 strains ofStreptococcus pneumoniae |
| No longer routinely given to people 65 and older | One dose for anyone 65 years and older |
| Only given if you and your doctor decide it is needed to protect you from risk, then one dose for those 65 and older | 如果您已经给了PCV13，那么您应该至少1年后获得PCV23 |
Pneumonia vaccines can prevent serious infections from the most common strains of pneumococcal bacteria.
根据这一点
Discuss your risks with your doctor to decide if you need both PCV13 and PPSV23 or if one shot is enough. Part B will cover both shots if required and given at least 1 year apart. For most people, one PPSV23 shot is enough.
Possible side effectsSide effects of pneumococcalvaccinesare generally mild. They include:
- 注射部位疼痛
- inflammation
- fever
- 头痛
Pneumococcal infections caused byStreptococcus pneumoniaecan be mild and common like ear infections or sinus infections. However, when the infection spreads to other parts of the body, it can be serious and cause pneumonia,meningitis， 和菌血症(bacteria in the bloodstream).
有些人患有肺炎感染的风险较高。它们包括2岁以下的儿童，成年人65岁及以上，免疫系统减弱的人和其他慢性健康状况的人diabetes,COPD, orasthma.
肺炎可以通过打喷嚏，咳嗽，触摸感染的表面很容易地传播，以及在具有高感染率的地区等医院的区域。根据CDC，20岁的老年人约1位死于肺炎球菌肺炎（肺部感染），如果他们得到它。
Along with the vaccines, you can increase prevention efforts by washing hands frequently, eating healthy foods, and reducing exposure to people who are sick when possible.
- Pneumococcal infections are common and can range from mild to severe.
- 肺炎疫苗降低了患有常见的肺炎球菌病的风险。
- Medicare Part B covers 100% of the cost for the two different types of pneumonia vaccine.
- Talk with your doctor if you think you need to take both vaccines. PCV13 is given first, followed by PPSV23 at least 1 year later.