Shingles in the elderly is a painful rash that affects your skin. Can you get shingles if you had the chickenpox vaccine? It depends. Anyone who has ever had chicken pox is susceptible to shingles. When the chicken pox virus comes out of hiding and reactivates, it causes symptoms such as numbness, tingling, blisters, and also sometimes flu-like symptoms. If you never had chicken pox because you were vaccinated, you run a very low risk of getting shingles.
There are an estimated 1 million new cases of shingles each year in the United states. The risk of an outbreak increases with age, so people over the age of 65 are more susceptible than younger adults. For this reason, many doctors encourage people on Medicare to get vaccinated. The age for shingles vaccine is 50 or older.
Pain and Complications of Shingles in Elderly People
Elderly people who develop shingles are often surprised at how painful it is. Many say that is far more painful than the original chickenpox virus that affected them in childhood. Often the skin in the area of the rash continues to hurt even after the rash has healed. The individual may feel stabbing or throbbing or even weakness. Doctors call this post-herpetic neuralgia, and it can sometimes last for months or even years.
There are also risks to older adults who develop shingles. The blistered area of skin can become infected, requiring antibiotics in addition to antivirals. Such infections can lead to scarring. The rash is also uncomfortable and makes it difficult to rest. When healing takes longer than normal, some individuals can feel despair or even depression. In rare cases, it can lead to encephalitis.
The virus can also be transmitted to other parts of your body, such as your eyes or lips. The herpes virus can cause outbreaks that may affect hearing and vision.
Another thing to be concerned about is contagion. While shingles itself is not contagious, the virus that causes it is. If your spouse has never had chickenpox and has not been vaccinated, he or she could develop chickenpox as an adult. It’s important to keep your skin clean and dry and prevent it from rubbing against any other person who could get infected.
Cost of Shingles Vaccine under Medicare Part D
Fortunately, there are a number of vaccines covered by Medicare Part D, including a shingles vaccine which has been effective for many individuals. It’s important to note that your Medicare Part B does not cover the shingles vaccine. This means if your doctor administers it to you, and bills Medicare, it won’t be covered.
However, many Part D drug plan carriers offer the vaccine, called Zostravax, on their formulary. Check your Part D drug formulary to make sure your plan covers it. Whoever administers the vaccine – your doctor or a pharmacist – needs to bill your Medicare Part D carrier. Most Part D plans will cover about 50% of the cost of the vaccine.
You will then pay only a co-payment or co-insurance for your share of the vaccine cost. While our experience has been that most Part D plans cover about half of the cost of the shingles vaccine, there may be plans available in your area that cover more. Our team can help you find a drug plan that includes the shingles vaccine on its formulary.
Shingles Medicare Billing Problems
Just a quick note about a billing issue that we commonly resolve for our clients. Many doctors continue to bill this to Medicare Part B and then the bill get rejected. Once the rejection happens, far too many Medicare beneficiary just pay these bills without questioning them. One astute client remembered that our Client Service Team provides FREE help resolving bills like these and called us for support.
Her doctor’s office had tried to bill her $710 for this medication – which is ridiculous! The shingles vaccine costs between $200 – $300. Most Part D plans will pay 50% of that. So don’t pay any medical bills that you receive without checking with us first.
Do you have questions about which Medicare plans will cover the shingles vaccine? Or perhaps you need help finding a drug plan that includes other vaccines covered by Medicare Part D? Give us a call.