On a shin­gles vac­cine and Medi­care Ad­van­tage

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Q: I heard there’s a new vac­cine for shin­gles. I’m 55 years old, but my part­ner is 62 and got the shin­gles shot last year. I’m con­fused over what we should do.


This is a great ques­tion and very much in the news. The FDA ap­proved the new shin­gles vac­cine (Shin­grix) in Oc­to­ber 2017. The vac­cine was rec­om­mended by ACIP and ap­proved by the CDC di­rec­tor in Fe­bru­ary 2018.

The new rec­om­men­da­tion is that ev­ery­one over 50 years old should re­ceive two doses of Shin­grix, 2–6 months apart, re­gard­less of past ex­po­sure to shin­gles or his­tory of Zostavax use. Those who re­ceived Zostavax at least two months pre­vi­ously should re­ceive two doses of Shin­grix 2–6 months apart.

The Shin­grix vac­cine is 95 per­cent ef­fec­tive in pre­vent­ing shin­gles. Although it is not a live virus vac­cine, it was not stud­ied in HIV pa­tients. Re­sults in HIV pa­tients should be pub­lished soon.

So, to an­swer your ques­tion, my rec­om­men­da­tion is that you should both re­ceive two doses of Shin­grix, 2–6 months apart. Please check with your pri­mary care­giver, as not all in­sur­ances have adopted the rec­om­men­da­tion and may not be re­im­burs­ing for the two-shot se­ries, which costs ap­prox­i­mately $270. Joel Rosen­stock, MD, MPH Chief Med­i­cal Of­fi­cer Ab­so­luteCARE Med­i­cal Cen­ter & Phar­macy

Q: I keep get­ting mail­ers from “Medi­care Ad­van­tage Plans.” What is the dif­fer­ence between Medi­care and Medi­care Ad­van­tage?


If you opt to get your cov­er­age through a Medi­care Ad­van­tage Plan, also known as Medi­care Part C, you still have Medi­care cov­er­age; how­ever, both your med­i­cal and (gen­er­ally) your pre­scrip­tion ben­e­fits will be con­tracted through a pri­vate com­pany. You may or may not be re­quired to pay an ad­di­tional pre­mium for your plan. Pa­tients are usu­ally re­spon­si­ble for a set co­pay for ser­vices, rather than a coin­sur­ance. The cov­er­age varies from plan to plan but all Ad­van­tage Plans must, at a min­i­mum, cover the same med­i­cal and pre­scrip­tion ben­e­fits cov­ered by Orig­i­nal Medi­care.

It is im­por­tant to re­mem­ber that with Ad­van­tage Plans, you may be re­quired to choose and stick with a Pri­mary Care Physi­cian. You may also need a re­fer­ral from your PCP to see a spe­cial­ist. Provider net­works for th­ese plans are more lim­ited than with Orig­i­nal Medi­care. You will need to be sure to see providers who are in-net­work for your plan or you will likely face higher out-of-pocket costs or pos­si­bly even no cov­er­age at all. Bethany Weikart Care Man­ager Ab­so­luteCARE Med­i­cal Cen­ter & Phar­macy

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