Lawmakers Seek to Address Medicare Vaccine ‘Sticker Shock’

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June 25, 2021 -- Federal lawmakers from both parties are seeking to end copays for vaccines for people enrolled in Medicare Part D pharmacy plans, intending to expand the use of these medicines.

In the House, 20 Democrats and 10 Republicans have signed on as co-sponsors to the Protecting Seniors Through Immunization Act of 2021 (HR 1978), introduced in March by Rep. Ann Kuster (D-NH). The companion Senate measure (S 912) has the backing of two Democrats and two Republicans. This legislation would end copays in Medicare Part D plans for vaccines recommended for adults by the CDC’s Advisory Committee on Immunization Practices.

Older Americans too often forgo vaccines due to “sticker shock” of copays charged for them, L.J. Tan, PhD, the chief strategy officer of the Immunization Action Coalition, told House lawmakers at a recent hearing.

Many people enrolled in Medicare get reminders about getting vaccines from their own adult children, who are in private insurance plans and don’t have copays. But when older people enrolled in Medicare Part D plans request these same vaccines, such as shots to prevent shingles at their pharmacy, they may be faced with costly copay demands, Tan said.

“They turn away and say, `You know I can't afford that right now because I'm on fixed income,’” Tan told the House Energy and Commerce Committee’s health ...

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