How to get the new COVID vaccine for free, with or without insurance


Federal health officials are urging Americans to contact their insurance companies after reports of some people encountering problems getting their new COVID-19 vaccine shot for free. These problems have occurred despite programs and requirements designed to make the images available without purchase price to all Americans.

The obstacles are new for this year’s commercial rollout of COVID-19 vaccines from Moderna and Pfizer, which is now listed for more than $100 on the private market. Earlier during the pandemic, vaccines and boosters everyone had been paid for by the federal government.

“There have been a number of errors with billing codes [and] shipment of vaccines,” Dr. Céline Gounder, CBS News medical contributor and public health editor at KFF Health News, said on “CBS Mornings” Tuesday.

Officials say this year’s hiccups in coverage of the shots should be temporary as insurers and vaccinators work to fix problems in the systems that handle billing for the shots.

“My sense is that these are bugs that will be fixed pretty quickly, but if not, please know first of all that you don’t have to pay out of pocket to get the COVID vaccine,” says health and Human Secretary Xavier Becerra told reporters on September 20.

Here’s the latest we know about the policies to make COVID-19 vaccines free, and how to find shots without cost.

Free COVID vaccine for people with insurance

Under federal law, plans must cover Vaccines against covid-19 at no cost to you through providers within your insurance company’s network.

If there are no vaccinators in your network who can offer the shot, insurance companies are required to cover the out-of-network service without cost sharing.

“If you have private insurance — whether it’s private, Medicare, Medicaid — you should have your free vaccine at no cost to you. It’s covered by insurance,” explained Gounder. “But because of these errors, there have been some issues. You may want to wait until early to mid-October just to get these things resolved. If you get your vaccine now, you may have to resubmit or appeal a denial. , but you should get it for free.”

ONE “cheat sheet” by the nonprofit KFF, seen below, lays out some details about coverage for Americans covered by private insurance, Medicare and Medicaid.

kff-covid-shot-insurance.jpg
A chart from the health policy nonprofit KFF details COVID-19 vaccine coverage rules by insurance type and for people who are uninsured.

KFF


The requirement to cover shots began immediately too updated fall 2023 photos after they were given the go-ahead by Food and Drug Administration officials saiddeletes a month long grace period private insurance companies typically have to implement new vaccines.

“I am writing to ask for continued partnership and also to remind you of legal obligations to cover the vaccines,” Becerra wrote in a letter dated 22 September to health insurance companies, with a description of the claim.

Becerra said federal health officials have been urging insurers for months to “start working on getting your systems ready” ahead of the fall vaccine rollout.

However, pharmacies and doctors have complained about problems with some insurers not updating their billing systems for the shots, leading some to be turned away from their deals.

“The guidance that the CDC and CMS put out earlier to be able to start implementing, a lot of plans didn’t even follow that,” Mitchel Rotholz of the American Pharmacists Association said on Sept. 22 at 1 p.m. meet of federal vaccine advisors.

Experts at the meeting acknowledged that rolling out rocks is far from unheard of for new vaccines, with other shots against RSV and pneumococcal bacteria also hitting problems in insurance coverage and availability this year.

“There needs to be some stronger enforcement to put that in place unless we’re going to continue to face these obstacles,” Rotholz said.

In his letter, Becerra said he urged insurers “to act as soon as possible.”

“In the meantime, I encourage consumers to reach out to their plans or issuers so you can meet your obligations as easily as possible,” he said.

Free COVID vaccine for people without insurance

Americans without insurance can find shots for free at sites in the federal “Bridge Access Program” run by the Centers for Disease Control and Prevention.

Sites with available images in the program can be found online through Vaccines.gov.

The include health centers supported by the federal government, vaccinators who get shots through their local health departments, and many retail pharmacies, including Walgreens and CVS.

Vaccinators in the Bridge Access program are supposed to give shots to uninsured Americans at no expense, after asking them if they have health insurance. Pharmacies in the program then receive payment from the federal government for each dose they administer.

Patients are not supposed to prove they don’t have health insurance to get free shots from the program. However, uninsured Americans who run into challenges can sometimes ask pharmacists to run their information into the system to show they’ve paid for prescriptions in the past.

“The Broad Access Program is designed to get rid of patient barriers to COVID-19 vaccines. The burden of verifying patient eligibility will be on our health systems, not on patients,” CDC said in an FAQ published about the program.


Leave a Reply

Your email address will not be published. Required fields are marked *