- Medicare covers tetanus shots, but the reason you need one will determine which part pays for it.
- Medicare Part B covers tetanus shots after an injury or illness.
- Medicare Part D covers the regular tetanus booster shot.
- Medicare Advantage plans (Part C) also cover both types of shots.
Tetanus is a potentially fatal condition caused by Clostridium tetani, a bacterial toxin. Tetanus is also known as lockjaw, because it can cause jaw spasms and stiffness as early symptoms.
Most people in the United States get tetanus vaccines as infants and continue receiving booster shots throughout childhood. Even if you get tetanus boosters regularly, you may still need a tetanus shot for a deep wound.
Medicare covers tetanus shots, but only in certain circumstances. It does not cover tetanus shots that are done routinely for preventive care, but Medicare will cover an emergency tetanus booster or vaccination in the event of a disease or injury that could expose you to tetanus toxin. Generally, Medicare Part D, if you have one of these plans, will cover preventive vaccinations. If you have a Medicare Advantage plan, you will need to check with your specific plan provider to find out what is covered.
Read more to learn the rules for getting coverage for tetanus shots, out-of-pocket costs, and more.
Medicare Part B is the part of original Medicare that covers medically necessary services and preventive care. Part B covers some vaccines as part of preventive care. These vaccines include:
- flu shot
- hepatitis B shot
- pneumonia shot
Part B covers the tetanus vaccine only when it’s a medically necessary service due to an injury, such as a deep wound. It doesn’t cover the tetanus vaccine as part of preventive care.
Medicare Advantage (Medicare Part C) plans must cover at least as much as original Medicare (parts A and B). For this reason, emergency tetanus shots must be covered by all Part C plans. If your Part C plan covers prescription drugs, it will also cover tetanus booster shots.
Medicare Part D provides prescription drug coverage for all commercially available shots that prevent illness or disease. This includes booster shots for tetanus.
Costs with Medicare coverage
If you need a tetanus shot because of an injury, you’ll have to meet your Part B annual deductible of $198 before the cost of the shot will be covered. Medicare Part B will then cover 80 percent of the Medicare-approved cost, provided you get the shot from a Medicare-approved provider.
You’ll be responsible for 20 percent of the cost of the vaccine, as well as any related costs, such as your doctor’s visit copay. If you have Medigap, these out-of-pocket cost may be covered by your plan.
If you’re getting a tetanus booster shot and have Medicare Advantage or Medicare Part D, your out-of-pocket costs may vary and will be determined by your plan. You can find out what your booster shot will cost by calling your insurer.
Costs without coverage
If you don’t have prescription drug coverage, you can expect to pay around $50 for a tetanus booster shot. Because this shot is recommended only once every 10 years, this cost is relatively low.
However, if you cannot afford the cost of this vaccine and your doctor recommends it for you, don’t let cost be a deterrent. There are coupons available online for this medication. The manufacturer of Boostrix, the most commonly prescribed tetanus vaccine in the U.S., has a patient assistance program, which may lower the cost for you.
Other cost considerations
There may be additional administrative costs when you get the vaccine. These are often standardized costs included in your doctor’s visit fee such as your doctor’s time, practice expenses, and professional insurance liability costs.
What they do
Tetanus vaccines are made from inactivated tetanus toxin, which is injected into the arm or thigh. An inactivated toxin is known as a toxoid. Once injected, the toxoid helps the body generate an immune response to tetanus.
The bacteria that causes tetanus lives in dirt, dust, soil, and animal feces. A puncture wound can potentially cause tetanus if bacteria gets under the skin. That’s why it’s important to keep up with your shots and seek care for any wounds that might cause tetanus.
Some common potential causes of tetanus include:
- puncture wounds from body piercings or tattoos
- dental infections
- surgical wounds
- burns
- bites from people, insects, or animals
If you have a deep or dirty wound and it’s been five years or more since you had a tetanus shot, call your doctor. You will most likely need an emergency booster as a safeguard.
When they’re given
In the United States, most infants receive a tetanus shot, along with inoculation against two other bacterial illnesses, diphtheria and pertussis (whooping cough). This childhood vaccine is known as a DTaP. The DTaP vaccine contains full-strength dosages of each toxoid. It’s given as a series of
Based on vaccine history, a booster vaccine will be given again at around 11 years or older. This vaccine is called a Tdap. Tdap vaccines contain full-strength tetanus toxoid, plus lower dosages of toxoid for diphtheria and pertussis.
Adults may receive a Tdap vaccine or a version that contains no pertussis protection, known as a Td. The Centers for Disease Control and Prevention recommends that adults get a tetanus booster shot
Possible side effects
As with any vaccine, side effects are possible. Minor side effects include:
- discomfort, redness, or swelling at the injection site
- mild fever
- headache
- body aches
- fatigue
- vomiting, diarrhea, or nausea
On rare occasions, the tetanus vaccine can cause a serious allergic reaction that requires immediate medical attention.
Tetanus is a serious infection that can be painful and long-lasting. It affects the body’s nervous system and can cause severe complications if left untreated. Tetanus can also cause trouble breathing and even cause death.
Thanks to vaccinations, there are only around 30 cases of tetanus reported in the United States each year.
Symptoms of tetanus include:
- painful muscle spasms in the stomach
- muscle contractions or spasms in the neck and jaw
- trouble breathing or swallowing
- muscle stiffness throughout the body
- seizures
- headache
- fever and sweating
- elevated blood pressure
- rapid heart rate
Serious complications include:
- involuntary, uncontrollable tightening of the vocal chords
- broken or fractured bones in the spine, legs, or other areas of the body, caused by severe convulsions
- pulmonary embolism (blood clot in the lungs)
- pneumonia
- inability to breathe, which can be fatal
Seek immediate medical attention if you have any symptoms of tetanus.
Regular vaccinations and good wound care are important for avoiding tetanus. However, if you have a deep or dirty wound, call your doctor to have it evaluated. Your doctor can decide if a booster shot is necessary.
- Tetanus is a serious and potentially fatal condition.
- Vaccinations for tetanus have nearly eliminated this condition in the United States. However, infection is possible, especially if you haven’t been vaccinated within the last 10 years.
- Medicare Part B and Medicare Part C both cover medically necessary tetanus shots for wounds.
- Medicare Part D plans and Part C plans that include prescription drug benefits cover regular booster vaccines.