Cost & Coverage

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MOST ADULTS 50 YEARS OR OVER ARE COVERED FOR SHINGRIX*

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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 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?
The majority of patients pay an out-of-pocket cost of less than $50 per dose.

WHAT ELSE SHOULD I KNOW?
More than 95% of Medicare Part D enrollees receive SHINGRIX at a pharmacy. Part D enrollees can only have SHINGRIX administered at a doctor’s office if that office uses a program called TransactRx to bill and be reimbursed by Part D plans for vaccines administered to enrollees.

MEDICAID PLANS

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AM I COVERED?

Coverage varies state by state. Medicaid covers SHINGRIX in two thirds of states (those who expanded Medicaid under the Affordable Care Act). Find out if your state expanded Medicaid

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. Find out if your state expanded Medicaid

WHAT ELSE SHOULD I KNOW?
To date, 38 states and the District of Columbia have expanded their Medicaid programs 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 fully out-of-pocket for SHINGRIX, individual costs may vary. Contact your 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

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.

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1 IN 3 PEOPLE WILL GET SHINGLES IN THEIR LIFETIME

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