Avisery has heard various reports about Medicare beneficiaries being denied coverage for COVID-19 vaccines. According to Medicare.gov, COVID-19 vaccines are covered for all Medicare beneficiaries at no cost. Please note that if an individual is in a Medicare Advantage plan, they may have to go to an in-network pharmacy or provider to receive the vaccine at no cost.
Conflicting Regulations Around COVID-19 Vaccine
Recent confusion surrounding Medicare coverage of 2025 COVID-19 vaccine results in part from the different regulatory bodies involved and also from variations in state-level vaccine guidance. Historically, vaccines receive approval at the federal level from both the U.S. Food and Drug Administration (FDA) and the Center of Disease Control (CDC)'s Advisory Committee on Immunization Practices (ACIP). Earlier this year, the FDA approved the 2025 COVID-19 vaccine only for individuals 65 and older, but on October 6, 2025, ACIP issued guidance approving use of the vaccine for anyone over the age of 6 months after consulting with a health care provider.
State agencies may also issue their own vaccine regulations. On September 12th, Governor Jay Pritzker signed an executive order to ensure vaccine access for all Illinois residents. Additionally, the Illinois Department of Public Health (IDOH)'s Illinois Immunization Advisory Committee issued guidance that recommends the COVID-19 vaccine for all individuals over the age of 6 months. IDPH provides an online Vaccine Locator Dashboard to help identify locations across the state where vaccines can be obtained.
If you have questions or need help counselingolder adults and adults with disabilities on Medicare, Medicaid, or other health benefits programs, reach out to Avisery's "Ask the Expert"service for professionals at
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