Tetanus, which is also known as lockjaw, is a serious bacterial infection caused by the Clostridium tetani bacterium. These bacteria exist everywhere in the environment but are most commonly found in dirt and manure. If the bacteria enter a wound, the body may become infected. Tetanus affects the brain and nervous system and can cause severe muscle spasms, problems breathing, muscle stiffness, and may lead to death.
Today in the United States there are very few cases of tetanus every year, with only around 30 reported cases. This is thanks to the common tetanus vaccine that provides protection against the bacterium and its invasion into the body.
When people are young, they receive the tetanus vaccine together with their diphtheria and pertussis vaccines. But for older people who are no longer being routinely vaccinated, protection against tetanus wears off. The Centers for Disease Control and Prevention (CDC) recommends that adults get a tetanus booster shot every ten years to maintain protection. This is why a routine tetanus booster should be part of a ten-year care plan for adults.
If you are no longer being routinely vaccinated or have not had a tetanus booster within the last ten years, you may need to know whether your Medicare benefits cover the cost of a tetanus shot and why you should have this protection.
Why Should You Get a Tetanus Shot?
Tetanus is no longer a common illness in the United States thanks to vaccination. But it can become life-threatening to those who are infected and unprotected.
When tetanus-causing bacteria enter the body through a wound, symptoms can occur anywhere between seven to ten days afterwards. Because tetanus affects the brain and central nervous system, the most common symptoms are muscle spasm and stiffness, beginning in the neck and throat area. For this reason, tetanus is also called lockjaw.
Additional signs of tetanus can include:
• Bloody stools
• Sore throat
• Rapid heartbeat
Do Medicare Recipients have Coverage for Tetanus Shots?
For Medicare recipients who have Medicare Part B (medical insurance), or a Medicare Advantage (Part C) plan, a tetanus shot is covered when it is part of necessary treatment for an illness or injury. However, Part B does not cover the Tdap vaccine which is the booster shot that includes tetanus, diphtheria, and pertussis.
If you have a Medicare Part D (prescription drug) plan, you may have coverage for commercially available shots that prevent illness, including the tetanus shot. Most Medicare Part D plans offer this coverage, but before you purchase the vaccine, make sure that your Part D plan covers it. You should also find out which pharmacy is included in your policy’s network. A representative for your insurance company can provide you with all the necessary details.
For people who do not have coverage with Original Medicare Part B, Medicare Advantage, or Medicare prescription drug policy, they may end up covering the cost of a tetanus shot out-of-pocket.
The average national cost for a tetanus and diphtheria combination vaccination is $60.00 per dose. Because this vaccination is effective for a ten-year period, the relative cost is not significant. If you are concerned about your Medicare coverage for vaccinations like tetanus or others, you can get information from a representative of your insurance provider.