ADPH: Future COVID-19 vaccinations, boosters shouldn’t cost you money

Published: Sep. 18, 2023 at 8:08 PM CDT
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BIRMINGHAM, Ala. (WBRC) - There is now a new and updated COVID booster, but with the government no longer footing the bill for COVID-19 vaccinations, will that cost now fall on you?

We’re On Your Side asking experts who will pick up the tab now, and what programs are out there to help you pay.

We spoke with Alabama Department of Public Health (ADPH) District Medical Officer Wes Stubblefield, and he says as he understands it, most insurances will cover the COVID-19 vaccine at no cost to you.

But, if you have insurance that doesn’t cover the entire cost, you could be eligible for a new bridge program that is being provided by the Department of Health and Human Services.

If you don’t have insurance, you are still eligible for that same program, and if you are under 18, you can get it through the vaccines for children program.

In other words, Stubblefield stresses that for those who want to get future shots or boosters, there will be ways to get them without paying out of pocket.

“Probably the best advice is that if you are desiring the vaccine, if you are going to use the county health department, that you contact the county health department, ensure they have the vaccine in stock and if not, make sure there is time to get the vaccine in stock so that you can receive the vaccine,” said Stubblefield.

Stubblefield says they are still in the early stages of this shift from past free vaccination efforts, but believes this can be done.

“We are aware that some consumers with private insurance have had difficulty accessing COVID-19 vaccines, including experiencing unexpected insurance coverage denials at the point of service. The Department has been working closely with the plans for months to ensure a seamless transition, and CMS has contacted plans and issuers again to make sure their systems are up-to-date and prepared to meet their obligations to provide coverage of COVID-19 vaccines for participants, beneficiaries, and enrollees. The Biden Administration will continue working to ensure COVID-19 vaccines are widely available to the American public at no cost to them from their local provider, community health center or pharmacy,” a U.S. Department of Health and Human Services (HHS) spokesperson said.

HSS says most forms of private health insurance must cover COVID-19 vaccines furnished by an in-network health care provider without cost sharing. This requirement became binding on September 11, 2023 once the FDA approved or authorized the vaccines. People should check with their plans for details about in-network coverage. People with Medicare coverage continue to have access to COVID-19 vaccinations without out-of-pocket costs. People with Traditional Medicare pay nothing for a COVID-19 vaccination if their doctor or other qualified health care provider accepts assignment for giving the shot. People with Medicare Advantage (MA) plans should contact their plan for details about payment for COVID-19 vaccines, but MA beneficiaries will pay nothing for a COVID-19 vaccination if they receive their vaccinations from an in-network provider.

Centers for Medicare & Medicaid Services (CMS) has updated its COVID-19 vaccine pricing webpage to include codes, descriptors, and Original Medicare pricing information for the recently approved COVID-19 vaccines. In addition, CMS sent a nationwide newsletter on September 14, 2023 with the latest updates on billing codes for the updated COVID-19 vaccines, according to HSS.

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