ST. LOUIS — The COVID-19 vaccine is being made available to Americans free of charge, but a question over insurance is causing some confusion over who really pays.
Lisa Cox with Missouri’s Department of Health and Senior Services cited federal guidance that applies to all states.
“The vaccine is completely free for people. They shouldn't be charged anything,” she said. “However, vaccinators do have the ability to bill insurance, Medicaid, Medicare.”
The bill is for administrative costs, like for the public health reporting and communication side of the process, plus patient outreach and education.
Health departments, hospitals, pharmacies and vaccination events all can be reimbursed for the work of getting people vaccinated.
“That's completely just to kind of help the vaccinator recoup any costs on their end, but it won't impact the patients,” said Cox.
The government's guide for insurance providers says the following: "The vaccine itself will be paid for through funding authorized by the CARES Act, but administration of the vaccine by a provider will be paid for by the payer." Here, payer refers to an insurance plan or the government's special fund to help get the shots to the uninsured.
Bottom line: you don't need insurance to get the shot and you should not be denied a shot at a vaccinator location if you aren’t able to provide proof of insurance.
Vaccine providers "are prohibited, by an agreement with the U.S. Government, from billing patients for the vaccine or its administration," according to the guidance.
This applies even if your vaccinator is otherwise out of network.
"Money, financial reasons will never keep anyone from being vaccinated,” said Cox.
It is important to note that this is all the system in place while COVID-19 is a national public health emergency. If it turns out people need regular vaccines to keep the virus at bay, it might become a scenario more like the flu shot, and cost or co-pay would depend on insurance provider or vaccinator location.