Thursday, September 28, 2023

Does Medicare Cover Hpv Vaccine

Dosage And Administration For Gardasil 9

Medicare & You: Vaccines

GARDASIL 9 should be administered intramuscularly in the deltoid or anterolateral area of the thigh.

  • For individuals 9 through 14 years of age, GARDASIL 9 can be administered using a 2-dose or 3-dose schedule. For the 2-dose schedule, the second dose should be administered 612 months after the first dose. If the second dose is administered less than 5 months after the first dose, a third dose should be given at least 4 months after the second dose. For the 3-dose schedule, GARDASIL 9 should be administered at 0, 2 months, and 6 months.
  • For individuals 15 through 45 years of age, GARDASIL 9 is administered using a 3-dose schedule at 0, 2 months, and 6 months.

Before administering GARDASIL 9, please read the Prescribing Information. The Patient Information also is available.

Medicare Advantage Plans May Cover More Vaccines Than Original Medicare

Medicare Advantage plans are sold by private insurance companies as an alternative to Original Medicare.

Every Medicare Advantage plan must provide the same hospital and medical benefits as Medicare Part A and Part B, and most plans include Medicare prescription drug coverage.

MAPDs must help cover a number of commercially available vaccines that arent covered by Original Medicare when reasonably and medically necessary to prevent illness. However, specific rules of administration and costs will vary depending on the Medicare Advantage plan you enroll in.

A licensed insurance agent can help you compare Medicare Advantage plans in your area, including what vaccinations may be covered.

Find Medicare plans that cover your vaccinations

Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

About the author

Christian Worstell is a senior Medicare and health insurance writer with He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles hes written, helping Americans better understand their health insurance and Medicare coverage.

Christians work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelors degree in journalism.

Number Of Doses Required

Depending on the persons age, two or three doses of the vaccine are required for the best possible protection.

For people under 18 years of age, experts believe that two doses of HPV vaccine will produce a sufficient immune response.

Based on various studies, experts believe that these two vaccines will produce a stronger immune response to HPV types 16 and 18 than two doses of Gardasil® 9. HPV 16 is responsible for most HPV-related cancers, especially cancers that affect men. Furthermore, these two vaccines provide immunity against the seven other types of HPV targeted by the Gardasil® 9 vaccine.

People aged 18 or older need three doses of Gardasil® 9.

These vaccines are more effective when the person being vaccinated has never had a HPV infection. Since the infection usually occurs in the first years of sexual activity, the vaccine should ideally be given before the person becomes sexually active. These vaccines are nonetheless indicated for people who have already had a HPV infection or lesion.

  • Itching at the injection site, fever

The Cervarix® vaccine causes a little more pain, redness and swelling at the injection site than the Gardasil® 9 vaccine.

To date, over 300 million doses of HPV vaccines have been administered worldwide. According to current scientific data, no serious or unexpected problems are associated with these vaccines. No link has been found between this vaccine and certain serious diseases or deaths.

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What Are The Vaccines Made From

HPV vaccines stimulate the immune system to prepare antibodies against these viruses. They do not contain viruses or parts of viruses. They are made from proteins that mimic the viral envelope and are unable to infect the person who is given the vaccine. In other words, these vaccines cannot transmit a HPV infection.

Like many other vaccines, HPV vaccines contain an adjuvant, which is used to increase the immune systems response to the vaccine. HPV vaccines do not contain any preservatives, latex, antibiotics, thimerosal or mercury.

HPV vaccines are developed in accordance with the usual process prescribed by Health Canada. This process regulates and oversees vaccine research, manufacturing, licensing, efficacy and safety. All vaccines must go through this process in order to be distributed in Canada.

The manufacturer of the Cervarix® vaccine has not taken steps for this vaccine to be licensed in Canada for use in boys. It is therefore approved for use in girls and women age 9 to 45. However, scientific data, including data from a study conducted in Québec, shows that this vaccine is safe and produces a similar immune response in boys and girls. In addition, in Europe this vaccine is approved for use in boys and girls age 9 or older. Norway has been using two doses of the Cervarix® vaccine for both boys and girls since September 2018.

For more information, consult How Vaccines Work.

What Are The Possible Side Effects Of Hpv Immunisation

The cancer

All medicines and vaccines can have side effects. Sometimes they are serious, most of the time theyre not.

For most people, the chance of having a serious side effect from a vaccine is much lower than the chance of serious harm if you caught the disease.

Talk to your doctor about possible side effects of HPV vaccines, or if after having a HPV vaccine you or your child have symptoms that worry you.

Common side effects of HPV vaccines include:

  • pain, redness and swelling where the needle went in

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What Vaccines Are Covered By Medicare

The following chart shows how some common vaccines are covered by Medicare.

Coronavirus 2019 – Part B You pay nothing for the vaccine, whether you receive 2 shots or only a single dose.
Influenza -Part B You pay nothing for 1 flu shot per flu season if your doctor accepts Medicare assignment.
Pneumococcal -Part B You pay nothing for 2 shots if your doctor accepts Medicare assignment.
Hepatitis B -Part B You pay nothing if youre at medium or high risk for Hepatitis B and your doctor accepts Medicare assignment.
-Medicare Advantage plans with drug coverage-Part D Coverage rules and costs vary by plan.
Tetanus -Medicare Advantage plans with drug coverage-Part D Coverage rules and costs vary by plan.

These are only a few of the most commonly recommended vaccines. Check with your doctor or health care provider if you have questions about a specific immunization or vaccine that is not listed here.

Medicare Part B also typically covers vaccines after youve potentially been exposed to a dangerous disease or virus. For example, your rabies shot may be covered by Medicare Part B if you are bitten by a dog.

Who Should Get Hpv Vaccine

HPV vaccination is recommended at ages 1112 years. HPV vaccines can be given starting at age 9 years. All preteens need HPV vaccination, so they are protected from HPV infections that can cause cancer later in life.

  • Teens and young adults through age 26 years who didnt start or finish the HPV vaccine series also need HPV vaccination.

CDC recommends that 11- to 12-year-olds receive two doses of HPV vaccine 6 to 12 months apart.

  • The first dose is routinely recommended at ages 1112 years old. The vaccination can be started at age 9 years.
  • Only two doses are needed if the first dose was given before 15th birthday.

Teens and young adults who start the series later, at ages 15 through 26 years, need three doses of HPV vaccine.

  • Children aged 9 through 14 years who have received two doses of HPV vaccine less than 5 months apart will need a third dose.
  • Three doses are also recommended for people aged 9 through 26 years who have weakened immune systems.

Vaccination is not recommended for everyone older than age 26 years.

  • Some adults age 27 through 45 years who are not already vaccinated may decide to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination for them.
  • HPV vaccination in this age range provides less benefit, because more people in this age range have already been exposed to HPV.

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What If I Don’t Qualify For Medicaid

If you don’t qualify for Medicaid but can’t afford to pay for the HPV vaccine out of pocket, you may be eligible for an HPV vaccine through the Section 317 Immunization Program. This program allows states to purchase and distribute vaccines and pays for local, state and national vaccination schemes to vaccinate low-income and uninsured citizens. Eligibility requirements vary widely depending on local priorities, and many schemes prioritize certain groups.

If your child is uninsured and doesn’t qualify for Medicaid, they may be eligible to enroll in the Children’s Health Insurance Program . Income-based eligibility criteria vary across states, but every CHIP program must pay for ACIP-recommended vaccines for its beneficiaries.

How Is The Hpv Vaccine Administered

June 22, 2022 ACIP Meeting – Human Papillomavirus (HPV) Vaccine

HPV vaccines are administered into the upper arm or thigh. People who are vaccinated between the ages of 9 and 14 should receive two HPV vaccine doses at least 5 months apart unless they are immunocompromised.

Immunocompromised people and those between the ages of 15 and 26 should receive three doses. The first two doses should be given at least 4 weeks apart, and the third dose should be given at least 12 weeks after the second. There should be an interval of no less than 5 months between the first and last doses.

Adults between the age of 26 and 45 should also be vaccinated following the three-dose regimen if they decide they want it following consultation with their doctor. The HPV vaccine can be administered with other vaccines during the same appointment.

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Merck Vaccine Program Income Eligibility Requirements

In 2021, you could qualify for the Merck assistance program if you made $51,520 or less as an individual, $69,680 or less as a couple, or $106,000 or less as a family of four.

Merck will also take special circumstances into account and makes exceptions on a case-by-case basis. Do not let the income qualifications deter you from applying. You may still be approved based on your specific situation.

For more information, call Merck Patient Assistance Program at 727-5400 or visit the company’s website.

How Well Do These Vaccines Work

HPV vaccination works extremely well. HPV vaccine has the potential to prevent more than 90% of HPV-attributable cancers.

  • Since HPV vaccination was first recommended in 2006, infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teen girls and 81% among young adult women.
  • Fewer teens and young adults are getting genital warts.
  • HPV vaccination has also reduced the number of cases of precancers of the cervix in young women.
  • The protection provided by HPV vaccines lasts a long time. People who received HPV vaccines were followed for at least about 12 years, and their protection against HPV has remained high with no evidence of decreasing over time.

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Who Should Not Get Hpv Vaccine

Tell your doctor about any severe allergies. Some people should not get some HPV vaccines if:

  • They have ever had a life-threatening allergic reaction to any ingredient of an HPV vaccine, or to a previous dose of HPV vaccine.
  • They have an allergy to yeast .
  • They are pregnant.

HPV vaccines are safe for children who are mildly ill, like those with a low-grade fever of less than 101 degrees, a cold, runny nose, or cough. People with a moderate or severe illness should wait until they are better.

Merck Vaccine Patient Assistance Program

Only half of young men open to getting HPV vaccine

The pharmaceutical company that manufactures the vaccine also has a vaccine assistance program to cover the cost of the vaccine itself. To qualify, you must:

  • Be between 19 and 45 years of age
  • Have no health insurance
  • Live in the United States
  • Have an annual income at or less than 400% of the Federal Poverty Level

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Vaccines Covered By Medicare Part D

Medicare Part D covers all commercially available vaccines needed to prevent illness. You can get Part D coverage through a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes drug coverage.

Vaccines covered by Part D include the following:

  • Shingles vaccine: One-time vaccine given in two shots over two to six months
  • Tdap vaccine : One shot if youve never been vaccinated, and a booster every ten years
  • Other vaccines covered: Vaccines that are “reasonable and necessary” to prevent illness and are not covered by Part B

Part D may also cover vaccines you may need if you are traveling internationally. Talk with your doctor about your travel plans and ask what vaccines are recommended.

Where Can I Get More Information

Your doctor or pharmacist can provide more information about this vaccine. Additional information is available from your local health department or the Centers for Disease Control and Prevention.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use how we develop our content .

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Cervical & Vaginal Cancer Screenings

Medicare Part B covers Pap tests and pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam, Medicare also covers a clinical breast exam to check for breast cancer. Medicare covers these screening tests once every 24 months in most cases. If youre at high risk for cervical or vaginal cancer, or if youre of child-bearing age and had an abnormal Pap test in the past 36 months, Medicare covers these screening tests once every 12 months.

Part B also covers Human Papillomavirus tests once every 5 years if youre age 30-65 without HPV symptoms.

If your doctor or other qualified health care provider accepts assignment, you pay nothing for the following:

  • the lab Pap test
  • the lab HPV with Pap test
  • the Pap test specimen collection
  • the pelvic and breast exams

Human Papillomavirus Vaccination Guideline Updates

Medicare, Medicaid Will Reportedly Cover COVID-19 Vaccine

Saslow and colleagues noted that the American Cancer Society presents an adaptation of the current ACIP recommendations for HPV vaccination. The ACS recommends routine HPV vaccination between ages 9 and 12 years to achieve higher on-time vaccination rates, which will lead to increased numbers of cancers prevented. Health care providers are encouraged to start offering the HPV vaccine series at age 9 or 10 years. Catch-up HPV vaccination is recommended for all persons through age 26 years who are not adequately vaccinated. Providers should inform individuals aged 22 to 26 years who have not been previously vaccinated or who have not completed the series that vaccination at older ages is less effective in lowering cancer risk. Catch-up HPV vaccination is not recommended for adults aged older than 26 years. The ACS does not endorse the 2019 ACIP recommendation for shared clinical decision-making for some adults aged 27 through 45 years who are not adequately vaccinated because of the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision-making on patients and clinicians, and the lack of sufficient guidance on the selection of individuals who might benefit.

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Where Can I Find These Vaccines

HPV vaccine may be available at doctor offices, community health clinics, school-based health centers, and health departments.

If your doctor does not stock HPV vaccine, ask for a referral.

You can also contact your state health department to learn more about where to get HPV vaccine in your community.

Getting The Vaccine From Tricare Authorized Providers

You can get covered vaccines from any TRICARE authorized provider.

  • If enrolled in a Prime option and want to get the vaccine from a non-network provider, you must have a referral and authorization to avoid paying point-of-service fees.
  • If you get the vaccine from your provider, you may have to pay copayments or cost-shares for the office visit or other services received during the office visit.

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Concerns About Side Effects Of Immunisation

If a side effect following immunisation is unexpected, persistent or severe, or if you are worried aboutsomeones condition after a vaccination, see your doctor or immunisation nurse as soon as possibleor go directly to a hospital.

You can report immunisation side effects to SAEFVIC, the Victorian vaccine safety and central reportingservice. In other states or territories, you can discuss with your immunisation provider how to reportadverse events.

It is important to seek medical advice for anyone who is unwell after vaccination, as this may be due toother illness rather than because of the vaccination.

Does Medicare Cover Pneumonia Shots


Medicare Part B typically covers pneumonia shots, which help prevent certain types of pneumonia.

Medicare Advantage plans also cover pneumonia shots. Many Medicare Advantage plans also cover prescription drugs and other benefits that Medicare Part A and Part B don’t cover.

Medicare typically covers 100 percent of the Medicare-approved amount of your pneumococcal vaccine .

Before getting your pneumonia shot, verify with your doctor that it is 100 percent covered by Medicare.

The Centers for Disease Control and Prevention recommends PPSV23 pneumococcal vaccinations for all adults who are 65 years of age or older.

There are currently two pneumococcal vaccines that have been approved for use for the prevention of pneumonia. Both vaccines are covered under Medicare Part B however, the order in which you receive them matters. Talk to your health care provider to learn more.

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