Understandably, all eyes are on the COVID-19 vaccination process: who is eligible, its availability, the side effects, and its effectiveness. We’re also all familiar with getting our annual flu shots each fall. Often overlooked, however, is the importance of getting a pneumococcal (pneumonia) vaccine.
Pneumococcal disease is a term used for a wide range of infections including:
• Ear infections;
• Sinus infections;
• Pneumonia (lung infection);
• Bacteremia (bloodstream infection);
• Meningitis (infection of the covering of the brain and spinal cord); and
• Sepsis (the body’s extreme response to an infection).
Mild symptoms include cough, ear pain, fever, and sore throat. More severe symptoms include fever or chills, cough, rapid or difficult breathing, chest pain, headache, stiff neck, increased pain when looking at bright lights, and confusion or low alertness. Pneumococcal bacteria spread from person to person through coughing, sneezing, and close contact. People can carry the bacteria in their nose and throat without being sick and spread the bacteria to others.
Some adults are at increased risk for pneumococcal disease, including those who:
• Are 65 years or older
• Use alcohol excessively
• Smoke cigarettes
• Have certain medical conditions of the heart, liver, kidney or lungs; diabetes or conditions that weaken the immune system; cochlear implants
Medicare Coverage of Pneumonia Vaccine
Medicare Part B covers two separate pneumonia vaccines. Part B covers the first shot if you have never received Part B coverage for a pneumonia shot before. You are covered for a different, second vaccination one year after receiving the first shot.
If you qualify, Original Medicare covers pneumonia shots at 100% of the Medicare-approved amount when you receive the service from a participating provider. Medicare Advantage Plans are required to cover pneumonia shots without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.
As with any vaccine, it is best to talk with your doctor about your specific conditions and any potential risks of side effects.
For more information, visit:
https://www.cdc.gov/pneumococcal/vaccination.html
https://www.medicare.gov/coverage/pneumococcal-shots
Article adapted from Senior Medicare Patrol (SMP) Scoop December 2021 Newsletter
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