Federal health authorities are urging Americans to contact their insurers regarding issues with obtaining the COVID-19 vaccine for free. Although programs and requirements have been put in place to ensure no out-of-pocket costs for all Americans, some individuals are facing hurdles. This is particularly evident in the commercial rollout of COVID-19 vaccines from Moderna and Pfizer, which are now being sold for over $100 on the private market. These issues include glitches with billing codes and shipping of vaccines. However, officials believe these problems are temporary and will be resolved as insurers and vaccinators work to fix the systems responsible for billing the shots. Health and Human Services Secretary Xavier Becerra assured the public that they should not have to pay for the COVID vaccine out of pocket. Under federal law, insurance plans are required to cover COVID-19 vaccines at no cost if received through providers in their network. If no vaccinators within the network can administer the shots, the plan must cover the service out-of-network without cost sharing. Individuals with private insurance, Medicare, or Medicaid are eligible for free vaccines. However, due to the aforementioned glitches, it is recommended to wait until October for the issues to be resolved. If vaccinated earlier, individuals may need to resubmit or appeal a denial, but they should still receive the vaccine for free. For those without insurance, shots can be obtained for free through the federal “Bridge Access Program” run by the CDC. Locations administering shots can be found online through Vaccines.gov. A “cheat sheet” provided by the nonprofit KFF offers more details on vaccine coverage based on insurance type or for uninsured individuals. Federal health officials have been urging insurers to prepare their systems ahead of the rollout of fall’s vaccines. However, some pharmacy and doctor offices have reported issues with insurers not updating their billing systems, which has led to individuals being turned away from appointments. The American Pharmacists Association also expressed concerns about the lack of enforcement regarding these requirements. Insurance companies were reminded of their legal obligations to cover the vaccines in a letter written by Health and Human Services Secretary Xavier Becerra. Those without insurance can seek free shots through the Bridge Access Program, which includes health centers, local health department vaccinators, and retail pharmacy locations. Vaccinators in the program administer shots to uninsured Americans at no cost, with payment coming from the federal government. Patients do not need to prove their lack of insurance, as the burden of eligibility verification lies with healthcare systems. In summary, federal health authorities are addressing issues with obtaining COVID-19 vaccines for free and are working to resolve glitches in the billing systems. Insurance plans are required to cover the vaccines at no cost if administered within their network, and uninsured individuals can access shots through the Bridge Access Program.
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