Short answer up top, then the exact rule. Here's what Original Medicare does and doesn't cover for the RSV vaccine in 2026 — and where a Medicare Advantage plan can fill the gap.
Quick answer: Yes — free with drug coverage. The RSV shot is covered by Medicare drug coverage (Part D), and you pay $0 — no copay and no deductible, because Part D covers all ACIP-recommended adult vaccines at no cost.
Medicare Advantage plans that include drug coverage (MA-PD) cover the RSV vaccine the same way — $0, no deductible. If your MA plan has no drug coverage and you have no standalone Part D plan, you'd pay out of pocket — one more reason to check your drug coverage each year.
Adults 75+, and adults 50–74 with health conditions that raise their RSV risk. Because the shot bills through Part D rather than Part B, a pharmacy is usually the smoothest place to get it — the pharmacy bills your drug plan directly.
See the current Part A, Part B, and Part D numbers — premiums, deductibles, and the new drug cap — in one place. Free, no signup.
See 2026 Medicare Costs →Yes — if you have Medicare drug coverage (a Part D plan or a Medicare Advantage plan with drug coverage), the RSV shot is $0. Part D plans can't charge a copay or apply a deductible to any ACIP-recommended adult vaccine.
No. The flu, COVID-19, pneumococcal, and hepatitis B shots run through Part B, but the RSV vaccine is covered under Part D (drug coverage) — like the shingles shot. It's still $0 with a drug plan; it just bills differently, so pharmacies are usually the easiest route.
Coverage gaps in Original Medicare — like the RSV vaccine — are exactly what a Medicare Advantage or Medigap plan is meant to fill. Our free Enrollment Finder shows the window you can switch in, and the guide library walks through the trade-offs. This page is free to share with anyone weighing their options.
Open the Enrollment Finder →This answer is based on U.S. government Medicare coverage rules: