We’ve said it before but it bears repeating: When an insurance company covers preventive care, you can bet it saves them money. Luckily, those same preventive services are good for you, too. Screenings help detect illness early, while it’s still easy to treat. And vaccinations help you avoid them altogether. Two vaccines covered by Medicare Part B (at no cost to you) are the flu and pneumococcal shots.
Why Do You Need a Flu Shot?
Influenza, commonly known as flu, is a highly contagious respiratory infection. Although the vast majority of Americans who get the flu each year recover within a few weeks, thousands die due to flu complications. The people at the highest risk of flu-related complications are:
- Adults over the age of 65
- Children under the age of 2 (severe risk) or 5 (high risk)
- Pregnant and postpartum women
- Long-term care facility residents
- Native Americans
In addition, numerous chronic medical conditions increase your risk of flu-related complications, including asthma, heart disease, and obesity.
How Often Should You Get the Flu Shot?
When it comes to preventing the flu, nothing has proved as effective as the flu vaccine. Unfortunately, the flu is different than most diseases for which you can be vaccinated. That’s because it’s a viral infection, and the virus mutates and changes. That means that the flu shot you got last year likely won’t protect you against this year’s virus.
The Centers for Disease Control (CDC) recommends getting the flu shot every year, before the end of October.
How Can You Prevent the Flu?
In addition to getting your flu shot every year, the best way to protect yourself is through healthy habits.
First, the disease spreads quickly and easily, so wash your hands often during flu season. Use warm water and soap, rubbing your hands together for at least 30 seconds before rinsing. Then, keep your hands away from your face, since this is the most common way people catch the flu (think of how often you touch surfaces others have touched, such as doorknobs and elevator buttons).
If you know someone is sick, keep your distance. The same is true if you’re sick, or even just think you are. Keep your germs to yourself and stay home from work and any other public places. When you cough or sneeze, cover your nose and mouth with a tissue or sneeze into your elbow – never your bare hand. Remember, hand contact is the most common way flu spreads.
What Are Common Flu Symptoms?
Influenza symptoms may include:
- Aching in muscles and joints
- Dry cough
- Extreme fatigue
- High fever that occurs suddenly
- Nausea, vomiting, and diarrhea (more common in children)
- Runny nose and congestion
- Sore throat
Most people recover within a few weeks but may continue to feel tired and run down, even after their other symptoms disappear. This is especially true for those at high risk of flu-related complications.
What Are Common Flu Complications?
Flu-related complications may be moderate, such as a sinus infection, or serious, such as pneumonia. Other serious complications include:
- Myocarditis, or inflammation of the heart
- Encephalitis, or inflammation of the brain
- Myositis or rhabdomyolysis, or inflamed muscle tissue
- Multi-organ failure, such as kidney and respiratory
- Sepsis due to an infected respiratory tract
- Worsening of chronic conditions, such as heart disease and asthma
If you are younger than 5 or older than 65, your risk of developing these complications rises significantly.
Emergency Warning Signs & Influenza
If you notice any of the following warning signs, it’s time to get to the emergency room.
- Pain or discomfort in the chest or abdomen
- Severe vomiting
- Shortness of breath or difficulty breathing
- Sudden feeling of dizziness
- Symptoms improve but then the fever returns and your cough is worse
Additional signs that it’s time to take a child to the emergency room include skin turning a bluish color, not drinking fluids, not interacting with others or wanting to be held, a rash, and crying without producing tears.
How Many Pneumococcal Shots Do You Need?
If you are an adult over the age of 65, the CDC recommends two pneumococcal shots. Medicare agrees and covers both vaccines, assuming you get them in the following order:
- PCV13: The pneumococcal conjugate vaccine protects you against 13 different pneumococcal strains
- PPSV23: The pneumococcal polysaccharide vaccine offers protection against 23 strains of the pneumococcal bacteria
You should not get the second shot, PPSV23, for at least 12 months after receiving the PCV13 vaccination. This rule is simple to follow, as Medicare only covers the second shot if it is delivered at least 12 months after the first. You can get either of these shots at the same time as the flu shot.
Who Should NOT Get the Pneumococcal Shots?
Although these vaccines are perfectly safe for most people, you should not get the PCV13 if you are allergic to any ingredient within the vaccine. In addition, don’t get the PCV13 shot if you had an allergic reaction to any vaccine that contains diphtheria toxoid or the PCV7 pneumococcal shot (an earlier version of the vaccine).
If you had an allergic reaction to the PPSV23 before, or are allergic to any of its components, you should not get the PPSV23 shot.
What Is Covered by Medicare?
Medicare Part B covers a variety of vaccines, including flu and both pneumococcal shots. Your cost is zero as long as your provider accepts assignment.
If you have any questions about your Medicare plan or coverage, call us toll-free at 855-350-8101 and one of our licensed agents will assist you.
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