Vaccine Coverage

How does Prevea360 Medicare Advantage cover vaccinations?

Prevea360 Medicare Advantage lists covered vaccines in our Formulary. A new preventive vaccine may not specifically appear in the formulary, but Prevea360 Medicare Advantage may still cover the vaccine. Please contact our Member Services at 1-877-232-7566 (TTY: 711) to find out about coverage.
 
Medicare Part B provides preventive coverage for certain vaccines, which includes:
  • Influenza: once per flu season.
  • Pneumococcal: once per lifetime with high-risk booster after 5 years.
  • Hepatitis B: for persons at intermediate- to high-risk.
  • Other immunizations are covered under Medicare Part B only if they are directly related to the treatment of an injury or direct exposure (such as antirabies treatment, tetanus antitoxin, antivenin, or immune globulin).
Receiving your vaccines in a physician’s office may mean you are financially responsible for the cost of the services, and will need to submit insurance claims on your own. To obtain the best benefit under your Part D plan, receive your vaccine from a network pharmacy that employs pharmacists certified to administer vaccines. Please contact Member Services at 1-877-232-7566 (TTY: 711) for a list of network pharmacies in your area that are certified to administer your Part D vaccine.
 
Learn more about the benefits of Vaccines and Immunization from the Centers for Disease Control and Prevention (CDC):
 

Questions?

Call 1-877-234-0126 (TTY: 711), 8 am to 8 pm, weekdays (year-round) and weekends (Oct. 1 – March 31), including for alternate formats and languages.

Mailing Address: 

Prevea360 Medicare Advantage
PO Box 56099
Madison, WI 53705