Capito, Hirono, Whitehouse Call on CMS to Make All Recommended Vaccines Accessible to Medicare Beneficiaries

WASHINGTON, D.C. – U.S. Senator Shelley Moore Capito (R-W.Va.) along with Senators Mazie K. Hirono (D-Hawaii) and Sheldon Whitehouse (D-R.I.) led a bipartisan group of their Senate colleagues in a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma requesting CMS make all recommended vaccines accessible to Medicare beneficiaries.

    Under current law, Medicare immunization coverage varies by vaccine. Some vaccines, like those that protect against influenza and pneumococcal infection, are available with no additional out-of-pocket spending. However, other vaccines—like the shingles vaccine—often require significant additional spending, which in turn contributes to lower vaccination rates, particularly for elderly, disabled, and chronically ill people.

    “As the current COVID-19 pandemic rages on around the globe, researchers are racing to find a vaccine to protect and prevent further morbidity and mortality as a result of this novel virus. Older adults and persons with chronic conditions such as heart disease, diabetes and lung disease are especially vulnerable to serious illness and complications from vaccine preventable disease. Yet, Medicare coverage design for vaccines for these populations does not encourage access to this proven and cost-effective form of prevention,” the senators wrote.

    The senators continued, “We encourage CMS to work with Part D sponsors to offer either a $0 vaccine tier, or to place vaccines on a formulary tier with low cost-sharing. Now is the time to empower vulnerable elderly and disabled Medicare beneficiaries with the tools they need to stay healthy and out of the health care system. Immunizations are one of the most reliable and efficient forms of prevention that we know save lives and billions in avoidable health care costs.”

    In addition to Senators Capito, Hirono, and Whitehouse, the letter was also signed by Senators Tim Scott (R-S.C.), Sherrod Brown (D-Ohio), David Perdue (R-Ga.), Tina Smith (D-Minn.), Thom Tillis (R-N.C.), Chris Van Hollen (D-Md.), Steve Daines (R-Mont.), Bob Casey (D-Pa.), and Pat Roberts (R-Kan.).

    Last year, Senators Capito, Hirono, and Whitehouse introduced the Protecting Seniors through Immunizations Act, which would improve access to vaccines by requiring all recommended vaccines, including shingles and tetanus, diphtheria, and pertussis (Tdap), be available to Medicare beneficiaries at no additional cost, with the goal of increasing vaccination rates.