To Improve Access And Equity, Move Vaccine Coverage To Medicare Part B

Sumit Agarwal, Nikhil Shankar, Marcella Alsan

Health Affairs Forefront, August 17, 2022

Within the Inflation Reduction Act of 2022 is a provision worthy of praise: the elimination of cost-sharing in Medicare for vaccines. The change is long overdue, but it could still fall short of substantially improving access and equity.

In this article, we discuss how Medicare’s coverage rules differ across vaccines and show that disparities are much starker for vaccines covered by Medicare Part D than those covered by Part B. This partly reflects differences in cost-sharing between Part B and Part D, which the Act addresses by matching Part B’s zero cost-sharing for vaccines in Part D, but there are other important barriers to consider as well: Not all Medicare beneficiaries have Part D, and even if they did, doctor’s offices are less likely to take Part D when it comes to administering vaccines.

We then argue that all vaccine coverage should be moved to Medicare Part B to further improve vaccination rates and reduce disparities in take-up of current and future vaccines.