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The initial rollout of the updated COVID-19 vaccines has hit a few bumps in the road with health insurers and providers, but efforts are underway to resolve the issues.
Last week, Americans, including Hawaii residents, faced insurance complications when trying to get the COVID-19 vaccines through the commercial market. However, most private insurers, Medicaid, and Medicare are required to cover the vaccines without any additional costs, according to U.S. Health and Human Services.
The Centers for Disease Control and Prevention recently recommended that everyone ages 6 months and older should receive the updated COVID-19 vaccines to protect against potential serious outcomes of illness during the upcoming fall and winter.
In Hawaii, some customers of HMSA were informed by CVS Pharmacy at local Longs Drugs stores that the vaccine was not covered and they would have to pay almost $200 out of pocket. As a result, many individuals decided to delay getting their COVID-19 shots.
However, HMSA’s vice president and chief medical officer, Dr. Stefanie Park, has announced that the technical issues behind these problems have been resolved. HMSA’s system has been updated and is now actively receiving claims. In addition, pharmacy partners have updated their workflows and will not charge HMSA members for the covered benefit. Members who paid out-of-pocket costs during this period can seek reimbursement within 30 days at the pharmacy where they received their vaccination.
CVS and Walgreens have begun offering appointments for the updated COVID-19 vaccines at their pharmacies, with Walgreens committed to ensuring that no patient has to pay.
Kaiser, on the other hand, has started offering the updated COVID-19 vaccines at its clinics statewide, but only to Kaiser members as part of routine vaccination coverage.
It’s important to note that most private insurance plans should cover the COVID-19 vaccines without any copays. However, insurance issues have been a nationwide problem. The American Lung Association is urging people to get vaccinated and is working to ensure that insurance coverage does not deter individuals from protecting themselves.
In addition to insurance confusion, accessing COVID-19 vaccines has presented other challenges. Some residents were able to secure vaccine appointments at nearby pharmacies, while others were not. Limited availability and last-minute appointment cancellations have frustrated many individuals.
The U.S. Department of Health and Human Services has reminded insurers of their legal obligations to cover any vaccine recommended by the Advisory Committee on Immunization Practices. Medicaid and Medicare are also required to cover the COVID-19 vaccines.
Despite the hurdles, the Hawaii Department of Health reported a decrease in daily COVID-19 cases and statewide positivity rates. However, it is crucial to reduce barriers to coverage and ensure that everyone has access to the updated COVID-19 vaccine.
Remember, we’re all in this together, and getting vaccinated is a vital step in protecting ourselves and our communities. Stay safe!
COVID vaccine coverage
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