General Resources

Pneumococcal Vaccine Recommendations for Adults 65 and Older

Insurance Coverage and Pneumococcal Vaccines

Most private health insurance covers pneumococcal vaccines.  Patients should check with their insurance provider for details on whether there is any cost to them and for a list of in-network vaccine providers.

There is new guidance for providers from Centers of Medicare and Medicaid Services (CMS) regarding payment for a second dose of Pneumococcal Vaccine via Medicare Part Bat:  http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9051.pdf

CMS regulations and guidance for Medicare claims processing can be found at:
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2014-Transmittals-Items/R3159CP.html

When specific guidance is available for Medicare beneficiaries, we will share it.

If you have questions about Medicare Part B coverage, you can send an email to CMS at: sec303ASPData@cms.hhs.gov; or call the Medicare Call Center at 1-800-MEDICARE (1-800-633-4227).

Additional information is also available on the MA Adult Immunization Coalition at: http://maic.jsi.com/