Medicare Excludes Vulnerable Groups from RSV Vaccine Coverage

Medicare Part D does not cover respiratory syncytial virus (RSV) vaccines for around 16 million beneficiaries, leaving seniors and pregnant individuals vulnerable to the virus. While RSV vaccines are covered under Part D, many beneficiaries are not enrolled in the program and have to pay out-of-pocket for the vaccine, which can cost upwards of $300. Even those with Part D coverage face challenges as doctor's offices are reimbursed for administering vaccines under Part B but not Part D, leading some patients to abandon the vaccine. The lack of coverage highlights the need for better policy making to ensure accessibility to all vaccines.