Exclusive: Biden Administration Secures Health Insurers’ Pledge to Cover COVID-19 Vaccines

The Department of Health and Human Services (HHS) recently held a meeting with representatives of the health insurance industry to address concerns regarding out-of-pocket costs for COVID-19 vaccine immunizations. Secretary Xavier Becerra met with executives from Anthem, Blue Cross Blue Shield (BCBS), the Better Medicare Alliance, CareFirst, Cigna, Humana, and CVS Health, including AHIP, the trade organization representing the health insurance industry.

Reports began to surface after the Centers for Disease Control and Prevention (CDC) approved the updated COVID-19 vaccines from Moderna and Pfizer, indicating that some individuals were having to pay up to $200 for their immunizations despite the expectation that insurers would cover the costs. AHIP suggested that the issue was related to updating billing codes for the new vaccines. Secretary Becerra, who personally received the vaccine, acknowledged the problem and reached out to insurance companies to address the issue.

During the meeting, insurance companies assured Secretary Becerra that these technical issues regarding vaccine coverage have been “largely if not completely” resolved.

In a letter to Secretary Becerra, AHIP, the Alliance of Community Health Plans, the Association for Community Affiliated Plans, and BCBS stated, “You have our commitment that health insurers are fully covering the new COVID-19 shots, as required, with no cost sharing when consumers access them from a network provider or receive them through an out-of-network provider when in-network options are unavailable.” They also mentioned their collaboration with the administration in preparing for the distribution of the new COVID-19 vaccines and resolving technical and coding issues promptly.

Additionally, the meeting resulted in BCBS including Walgreens in its network for federal employees, as HHS raised concerns about the pharmacy chain’s in-network status.

While the billing code issue raised questions about whether the federal government had kept insurers informed about the vaccines, HHS clarified that it had been regularly meeting with these companies over the past year.

HHS also provided an update on the vaccination efforts in the U.S. Although vaccination rate data is no longer being updated on the CDC’s website, HHS reported that over 2 million people have been vaccinated, and more than 6 million vaccines have been shipped to pharmacies. The Biden administration’s initiative to provide at-home COVID tests has resulted in over 8 million orders.

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