- People in the United States won’t need to pay for a coronavirus vaccine.
- It’s unclear how much the vaccine could cost on the other side of the pandemic.
- Uninsured people will also be able to get vaccinated for free during the pandemic.
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It’s official: The COVID-19 vaccine will be free for all, regardless of whether you have private health insurance, are uninsured, or are on Medicare.
That is, people in the United States won’t need to shell over any cash for a coronavirus vaccine.
Many have wondered if the vaccine will come with unexpected costs, such as copays or administration fees. But private insurers and the Health Resources and Services Administration (HRSA) have confirmed the vaccine and appointment will be free, at least throughout the pandemic.
It’s unclear how much the vaccine could cost on the other side of the pandemic, but health insurance experts suspect people privately insured or on Medicare will still be able to get vaccinated at no cost.
After the pandemic, there may be a higher price for uninsured individuals.
Here’s what to know about paying for a coronavirus vaccine:
The vaccine will be covered for people with private insurance, according to guidelines released by the Centers for Medicare and Medicaid Services (CMS).
“Health insurers whose plans are subjected to the coverage of preventive services without cost-sharing requirement under the Public Health Service Act are not allowed to bill patients for the administration of the COVID-19 vaccine,” said Anh Nguyen, PhD, a health economics expert and assistant professor of economics at Carnegie Mellon University’s Tepper School of Business.
Nguyen noted that this applies to both in-network and out-of-network providers.
Private insurers such as Blue Cross Blue Shield (BCBS) and Oscar Health confirmed members will pay $0 for the vaccine.
“If the primary purpose of a patient’s visit is to receive the COVID-19 vaccine, BCBS companies will cover the vaccine, administration services, and the office visit at no cost-share to the patient, even if the appointment is out-of-network, per regulations issued by CMS,” a BCBS spokesperson told Healthline.
If the doctor’s visit includes health services unrelated to COVID-19, the person may be charged.
“If a patient receives additional, non-COVID-19 care at the same appointment, patients will be covered for those services in accordance with their health plan,” the BCBS spokesperson said.
Oscar Health, too, has committed to providing the vaccine for free to its members. There will be no charge for the vaccine itself or for the doctor’s visit associated with the immunization, Oscar Health confirmed.
“People receiving the COVID-19 vaccine will not be billed with copays or unexpected administrative fees,” an Oscar Health spokesperson said. “Based on guidance so far from the federal government, plans and issuers must cover COVID vaccines without cost sharing.”
According to Nguyen, this coverage benefit doesn’t apply to certain alternative healthcare plans, such as short-term limited duration insurance. Individuals on alternative plans may be subjected to copay or administration costs related to the vaccine.
Some states may require these plans to cover costs related to COVID-19 similarly to how they did with testing for the disease.
The CMS also states there will be no vaccine costs, administration fees, or deductibles for people on Medicare.
Any COVID-19 vaccine that receives Food and Drug Administration (FDA) authorization “will be covered under Medicare as a preventive vaccine at no cost to beneficiaries,” the CMS states on its website.
Uninsured people will also be able to get vaccinated for free during the pandemic.
“People without health insurance or whose insurance does not provide coverage of the vaccine can also get COVID-19 vaccine at no cost,” the CMS states.
Healthcare providers that administer the vaccine to uninsured people will need to submit a reimbursement claim to the Provider Relief Fund. The fund is handled by the U.S. Department of Health and Human Services (HHS), which will reimburse healthcare providers.
Providers who participate in and are reimbursed by the Provider Relief Fund, a part of the HRSA COVID-19 Uninsured Program, aren’t allowed to bill people without insurance.
Uninsured patients may be hit with a fee if the provider doesn’t submit a claim to the relief fund.
“If the provider doesn’t submit a bill for COVID-19-related testing and/or treatment to the HRSA COVID-19 Uninsured Program, or the care was not eligible for reimbursement from the program, the patient may be responsible for full payment of the bill,” an HRSA spokesperson said.
There are no steps uninsured people will need to take prior to getting vaccinated, the HSRA spokesperson confirmed.
Though it’s unclear what the COVID-19 vaccine will cost when the pandemic is over, it’ll likely be handled similarly to other important vaccinations, such as the flu shot and measles-mumps-rubella (MMR) vaccine.
“For health insurance plans that are subjected to the coverage of preventive services without cost-sharing requirement, the CARES Act ensures that the COVID-19 vaccine will be added to the list of required preventive care coverage without the 1-year delay,” Nguyen said.
People on private health insurance plans or Medicare Part B will most likely be able to get the vaccine for free.
“After the federal public health emergency period ends, insurers will cover the COVID-19 vaccine in line with essential health benefit coverage rules,” the Oscar Health spokesperson said.
The future vaccine costs for uninsured people is less concrete, but Nguyen suspects it may be pricier than other routine vaccinations.
“For the uninsured, I expect the cost to be higher than that of a flu vaccine due to the cold storage requirement of the vaccine,” Nguyen said. “Furthermore, there is no regulation on how much providers can charge uninsured patients once the pandemic status is lifted.”
During the pandemic, the COVID-19 vaccine will be free for all, regardless of whether you have private health insurance, are uninsured, or are on Medicare.
Administration fees for immunization-related appointments will be free as well.
After the pandemic, the vaccine will likely be covered as a preventative service for people on Medicare or private insurance. However, those who are uninsured may see a bigger price tag.