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COST & COVERAGE

MOST ADULTS 50 YEARS AND OLDER ARE COVERED FOR SHINGRIX*

  •  
  • PRIVATE INSURANCE

Patients typically pay no out-of-pocket costs per dose.

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  • MEDICARE PART D

Majority of patients pay an out-of-pocket cost of less than $50 per dose.

*Coverage and cost may vary and are subject to change without notice. Reimbursement decisions are made by individual insurance plans.

COST & COVERAGE INFORMATION

Select the option that applies to you:

 

PRIVATE INSURANCE/ACA

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AM I COVERED?Insurance plans covering 96% of commercially insured members cover SHINGRIX.

WHERE SHOULD I GET SHINGRIX?

Pharmacy
In-network doctor’s office

HOW MUCH WILL SHINGRIX COST?

90% of privately insured patients 50 years and older pay no or limited out-of-pocket costs with the average cost being less than $5 per dose.

WHAT ELSE SHOULD I KNOW?

The Affordable Care Act (ACA) requires all Health Insurance Marketplace plans and most other private health insurance plans to cover all ACIP-recommended vaccines, including SHINGRIX, with no cost sharing (deductibles, copayments, or coinsurance) if administered in-network.

ACIP=Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

MEDICARE PART D

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AM I COVERED?SHINGRIX is covered under Medicare Part D.

WHERE SHOULD I GET SHINGRIX?

Pharmacy

HOW MUCH WILL SHINGRIX COST?

Most patients pay an out-of-pocket cost less than $50 per dose.

WHAT ELSE SHOULD I KNOW?

More than 95% of Medicare Part D enrollees receive SHINGRIX at a pharmacy. Most doctors’ offices cannot bill for vaccinations for Part D enrollees. If you’d like to receive SHINGRIX at your doctor’s office, ask them if they're able to bill for Part D before vaccination.

MEDICAID

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AM I COVERED? Coverage varies state by state. Medicaid covers SHINGRIX for patients 50 years and older in two-thirds of states (those that expanded Medicaid under the Affordable Care Act).

WHERE SHOULD I GET SHINGRIX?

Pharmacy
In-network doctor’s office

HOW MUCH WILL SHINGRIX COST?

If your state expanded Medicaid, SHINGRIX is likely covered by your plan with no cost-sharing if administered in-network with the average cost being less than $5 per dose.

WHAT ELSE SHOULD I KNOW?

To date, 38 states and the District of Columbia have expanded their Medicaid program and are likely to cover SHINGRIX. The remaining 12 states are less likely to cover SHINGRIX.

FIND OUT IF YOUR STATE EXPANDED MEDICAID

UNINSURED/OUT-OF-POCKET

WHERE SHOULD I GET SHINGRIX?

Pharmacy
Doctor’s office

HOW MUCH WILL SHINGRIX COST?

If you’re paying out of pocket for SHINGRIX, individual costs may vary. Contact your healthcare provider to learn more about your expected cost.

WHAT ELSE SHOULD I KNOW?

GSK offers programs to help patients without insurance access with the cost of their medications, including SHINGRIX. To learn more, visit GSKForYou.com

THE IMPACT OF SHINGLES

When considering vaccination, It’s important to consider how getting shingles could potentially impact you.

Shingles can cause pain that lasts for weeks and can be disruptive. Beyond the painful, itchy rash, some people experience complications that can lead to long-term health problems—the most common is postherpetic neuralgia (PHN), severe pain that can last for months or even years. SHINGRIX is not indicated to prevent complications from shingles, including PHN.

Icon: 1 out of 3 people in the U.S.

1 IN 3 PEOPLE  WILL GET SHINGLES IN THEIR LIFETIME