Federal health authorities are encouraging Americans to contact their insurance providers following reports of some individuals encountering difficulties in obtaining their new COVID-19 vaccine without charge. Despite programs and requirements intended to ensure that vaccines are accessible to all Americans at no cost, issues have arisen during this year’s commercial rollout of COVID-19 vaccines from Moderna and Pfizer, which are now priced at over $100 on the private market. Earlier in the pandemic, vaccines and boosters were entirely covered by the federal government.
Officials believe that the issues with vaccine coverage this year should be temporary, as insurers and vaccinators work to resolve billing system problems. Health and Human Services Secretary Xavier Becerra emphasized that individuals should not have to pay out of pocket for the COVID vaccine.
Under federal law, health plans are obligated to cover COVID-19 vaccines at no cost when administered by in-network providers. If in-network providers are unavailable, insurers are required to cover the service out-of-network without cost sharing.
The requirement to cover the vaccines was implemented immediately for the updated fall 2023 shots after FDA approval, eliminating the typical grace period that private insurance companies have for implementing new vaccines.
Health insurers have been urged for months by federal health officials to prepare their systems ahead of the fall vaccine rollout. However, some pharmacies and doctors have reported issues with insurers failing to update their billing systems for the shots, resulting in patients being turned away from their appointments.
For uninsured Americans, free COVID-19 shots are available through the federal “Bridge Access Program” run by the CDC. These shots can be found at designated locations, including federally supported health centers, local health department-affiliated vaccinators, and major retail pharmacies like Walgreens and CVS. Uninsured patients should not be required to prove their lack of insurance to receive free shots through the program.
The program is designed to eliminate barriers to COVID-19 vaccination, and the burden of verifying patient eligibility is placed on healthcare systems rather than patients themselves, as stated in an FAQ provided by the CDC.
In summary, some Americans have faced challenges in accessing the new COVID-19 vaccine for free despite federal requirements. These issues are expected to be temporary as insurers and vaccinators work to resolve billing system problems. Uninsured individuals can access free vaccines through the federal Bridge Access Program without the need to prove their lack of insurance.
Despite federal requirements and programs designed to provide COVID-19 vaccines at no cost to all Americans, some individuals have encountered obstacles in obtaining their shots without charge. This issue arose during the commercial rollout of the new COVID-19 vaccines from Moderna and Pfizer, which are now priced at over $100 on the private market. Previously, the federal government covered the costs of vaccines and boosters.
Officials believe that these coverage issues are temporary and should be resolved as insurers and healthcare providers address billing system challenges.
Under federal law, health insurance plans are mandated to cover COVID-19 vaccines without any cost-sharing requirements when administered by in-network providers. If in-network providers are not available, insurers must cover the service out-of-network without cost sharing.
This requirement went into effect immediately for the updated fall 2023 vaccines after FDA approval, bypassing the typical grace period for private insurance companies to implement new vaccines.
Health insurers were encouraged by federal health officials to prepare their systems for the fall vaccine rollout well in advance. However, some pharmacies and healthcare providers have reported issues with insurers failing to update their billing systems, resulting in patients being turned away from their vaccination appointments.
For uninsured Americans, free COVID-19 vaccines are available through the federal “Bridge Access Program” administered by the CDC. These vaccines can be found at designated locations, including federally supported health centers, local health department-affiliated vaccinators, and major retail pharmacies like Walgreens and CVS. Uninsured patients should not be required to prove their lack of insurance to receive free shots through this program.
The program is designed to eliminate barriers to COVID-19 vaccination, and the responsibility of verifying patient eligibility lies with healthcare systems rather than patients themselves, as stated in an FAQ provided by the CDC.
Appointments can be scheduled by visiting Walgreens.com/ScheduleVaccine, using the Walgreens app or calling 1-800-WALGREENS. Additional appointments will be added daily as inventory arrives at stores.
