Medicare Part D Vaccine and Administration (Injections)
Medicare Part B covers most of the vaccines that Medicare patients need. However, vaccines not covered under Part B are generally covered under Part D. Providers who administer Part D vaccines to members may receive payment under our plan’s Medicare Prescription Drug (Part D) program.
For more information about Medicare Part D Vaccine and Administration Payments, please see the Centers for Medicare & Medicaid Services brochure below.
Access options for Virginia Premier Medicare Members:
1. In-Network Pharmacy Administers the Vaccine
Patients receive a prescription from the physician and the vaccine is administered by a licensed pharmacist at a local, in-network pharmacy (unless prohibited by law). The pharmacy bills Virginia Premier Part D, and the patient pays the pharmacy any required prescription copay amount.
2. In-Network Physician Administers the Vaccine (Reimbursement Form to be Submitted by Physician)
Physician obtains vaccine and administers it to the patient. In this case, the physician would initially be responsible for the cost(s) associated with obtaining and administering the vaccine. The physician would then submit a claim (see form below) for reimbursement of covered Part D vaccines and their administration.
Providers seeking reimbursement of covered Part D vaccines and their administration (injection) should complete the form below.