Shingles Vaccination Coverage

Based on the endorsement and recommendation from the Centers for Disease Control and Prevention (CDC), TRICARE will cover a single dose of the vaccine designed to prevent shingles for eligible beneficiaries age 60 and older.

What is Shingles?

Shingles is a painful skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox. Symptoms can also include fever, headache, chills and an upset stomach. Only people who have had chickenpox—or who have received the chickenpox vaccine—can develop shingles later in life. You cannot catch shingles from someone else who has shingles.

Who is Eligible?

Talk to your health care provider about getting vaccinated. The CDC does not recommend the vaccine if you have:

• Active, untreated tuberculosis
• Had a life-threatening allergic reaction to any component of the shingles vaccine, including gelatin or the antibiotic neomycin
• A weakened immune system (because of HIV/AIDS or a drug treatment)
• A history of cancer or are currently being treated for cancer.

You are eligible at age 60 and older. Your associated costs are based on your TRICARE program:

TRICARE Prime

You will not have a deductible or copay if you get the shingles vaccine from your primary care manager (PCM). A point of service penalty may apply if you receive the vaccine elsewhere.

TRICARE Standard/Extra

You may get your shingles vaccine from any TRICARE-authorized provider (network or non-network) who is licensed to give the vaccine. Deductibles and cost shares will apply.

TRICARE For Life and Medicare Part D

It is important to know which Medicare coverage you have—the shingles vaccine is covered under Medicare Part D. Please note that Medicare Part D (prescription drug plan) coverage is optional, separate from other Medicare coverage and is not required for TRICARE For Life coverage.

With Medicare Part D: Medicare (when you have Part D) will be the primary payer for the shingles vaccine. You should contact your Part D plan for more information about Medicare’s shingles vaccine coverage and any associated costs.

Without Medicare Part D: If you do not have Medicare Part D, TRICARE For Life (TFL) will be the primary payer for the vaccine. You may get the shingles vaccine from any TRICARE-authorized provider (network or non-network) who is licensed to give the vaccine. There is an annual deductible ($150 individual or $300 family) and cost shares for your TFL coverage.

You should contact your local military treatment facility or primary care manager for information on the shingles vaccine availability.