Medicare Advantage vaccine coverage from WellFirst Health — Provided by SSM Health Plan

nurse giving a patient a vaccine

Important message about what you pay for vaccines

Our plan covers most Part D vaccines at no cost to you — even if you haven't paid your deductible. Call the Customer Care Center listed on your ID card for more information.

How are vaccinations covered?

Members can find covered vaccines listed in our formulary. A new preventive vaccine may not specifically appear in the formulary, but we may still cover the vaccine. Contact our Customer Care team at 1-877-232-7566 (TTY: 711) to find out about coverage. Your plan covers both Part B and Part D vaccines at $0.

New for 2023: You are now able to get your preventative vaccines at your network retail pharmacy or at your doctor office during a regular visit.

Our plan provides preventive coverage for certain vaccines at $0, including:

Influenza: once per flu season
COVID-19: per CDC guidelines
Pneumococcal: once per lifetime with high-risk booster after five years
Hepatitis B: for persons at intermediate- to high-risk
Other immunizations are covered under Medicare Part B only for those who meet coverage rules and are at high risk

See your formulary for a full list of covered vaccines at $0 copay.

Learn more about the benefits of vaccines and immunization from the Centers for Disease Control and Prevention (CDC): Vaccines and Immunizations: The Basics.

Questions? Contact us.

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Members

Talk with our Customer Care Center at 877-301-3326 (TTY:711).

Not a member?

Talk with one of our Medicare sales reps at 833-942-2158 (TTY:711) You can also call to ask for information in alternate formats and languages.