"CDPH received clarification on coverage of the pertussis booster vaccine (Tdap) from
the Centers for Medicare and Medicaid Services (CMS) regarding coverage of Tdap
immunization for beneficiaries. Tdap vaccine is a Part D covered drug for use in
patients 65 years of age and older. Tdap vaccine may be obtained by Medicare Part D
beneficiaries from a network pharmacy without out-of-pocket costs by the beneficiary.
Tdap may also be provided in a network providerâ€™s office; however, this would require
the beneficiary to pay for the vaccine costs up front and then be reimbursed by their
Medicare Part D plan. The beneficiary should contact their Medicare Part D plan in
advance for detailed instructions on reimbursement for Tdap vaccination."
"CMS reminds Part D sponsors that the Tdap vaccine is a Part D covered drug and is on-compendia for use in patients 65 and older. The Tdap vaccine may be obtained from a network pharmacy and administered by a pharmacist registered for vaccine administration or in a network providerâ€™s office. This will benefit members by providing a choice in access and administration to the vaccine."
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