CDC: COVID vaccine is free, don’t pay anything out-of-pocket
Woman charged “administration fee” for COVID vaccine, provider said it was following state guidance. ADPH is making changes after hearing what happened.
SHELBY COUNTY, Ala. (WBRC) – Kelly Campbell is fully vaccinated against COVID-19 and for each dose of protection, she was charged $20.
“I mean, I am happy I got my vaccines, but it bothers me I had to pay $40 total for it,” said Campbell, who lives, works and got her vaccines in Shelby County.
Campbell’s supervisor at work found a provider close to their office offering vaccines. They made appointments and in late February, Campbell and a few co-workers walked into the office and before rolling up their sleeves, were asked to open their wallets.
“We came in and they said, ‘It’s going to be $20 cash,’ and we asked, ‘What are we were being charged for?’ and they said, ‘That’s how we pay our nurses.’ And, we all actually tried to pay with credit cards because we weren’t prepared to pay, and she said, ‘We don’t take credit cards for this. We only take cash.’”
The COVID-19 vaccine is free and while providers are not expected to work for free, the Centers for Disease Control and Prevention (CDC) explicitly states on its website: “All organizations and providers participating in the CDC COVID-19 Vaccination Program must administer COVID-19 Vaccine at no out-of-pocket cost to the recipient.”
The Centers for Medicare and Medicaid (CMS) adds, “As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers are prohibited from charging patients any amount for administration of the vaccine.”
Administration fees may be billed to private insurance companies, Medicare or Medicaid, or the federal government’s COVID-19 uninsured program, according to the CDC.
WBRC FOX6 reached out to the provider where Campbell got her vaccines and was told they did charge the administration fee and did so following guidance from the Alabama Department of Public Health (ADPH).
The provider pointed to the “COVID-19 Vaccination Provider Support” page on ADPH’s website as their reference and the specific line under the “COVID-19 Vaccine Administration Fee” section that reads in-part, “Vaccine providers will be able to charge an administration fee. However, the CDC Provider Agreement states that participating providers must administer COVID-19 vaccine regardless of the vaccine recipient’s ability to pay COVID-19 vaccine administration fees or coverage status.”
The provider told WBRC they were doing what was “allowed” and did not deny the vaccine to anyone who could not or refused to pay the administration fee.
“Persons should not be charged for a COVID-19 vaccine in Alabama or any other state in the U.S.,” said Dr. Karen Landers, ADPH.
Dr. Landers said after hearing about Campbell’s case and the provider’s explanation, ADPH will change the guidance for providers on its website.
In a statement, Dr. Landers told WBRC, “The Alabama Department of Public Health (ADPH) reminds that all COVID 19 vaccines are free. Insurance or other third party can be charged an administrative fee. However, if persons do not have insurance or third party resource, they are not to be charged an out of pocket fee. ADPH counties to reach out to provider to remind of this and is changing language on the website to ensure that providers understand that the vaccine is free.”
The CDC says COVID-19 vaccination providers cannot:
- Charge you for the vaccine
- Charge you directly for any administration fees, copays, or coinsurance
- Deny vaccination to anyone who does not have health insurance coverage, is underinsured, or is out of network
- Charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination
- Require additional services in order for a person to receive a COVID-19 vaccine; however, additional healthcare services can be provided at the same time and billed as appropriate
COVID-19 vaccination providers can:
- Seek appropriate reimbursement from the recipient’s plan or program (e.g., private health insurance, Medicare, Medicaid) for a vaccine administration fee However, providers cannot charge the vaccine recipient the balance of the bill
“Providers that charge impermissible fees must refund them and ensure that individuals are not charged fees for the COVID-19 vaccine or vaccine administration in the future,” according to The U.S. Department of Health and Human Services Officer of the Inspector General.
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