The only vaccines covered under Medicare part B are influenza, pneumonia, hepatitis B ( for medium & high risk patients), and vaccines related to an acute injury or illness (rabies vaccine for dog bite, tetanus vaccine for stepping on rusty nail, etc.). All other vaccines are covered under Medicare part D. The patient can obtain these vaccines at the pharmacy, and the pharmacy can bill the patient's part D plan directly. Or the patient can obtain the vaccines at the doctor's office, but the patient will have to pay for the vaccine and administration fee up front to the doctor, and will then have to file a claim to their part D plan for reimbursement. As for the shingles vaccine requiring a prescription, I think it depends on the state. I know in Maryland where I live, a prescription is required.