Getting Your Next Covid-19 Vaccine, With Or Without Insurance

Federal authorities are urging Americans to get the new Covid-19 vaccine, and to reach out to their insurers if they’re having issues getting the shot for free, as it’s been made available for no cost to any American citizen. 

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Health authorities in America are urging citizens to reach out to their insurance providers after reports that some individuals are having trouble getting their new Covid-19 vaccine for free, despite the fact that there are currently numerous programs and requirements in place to make the shots completely free and available for all Americans. 

Some have even reported that the new Covid-19 vaccines from Moderna and Pfizer are being listed for more than $100 on the private market. Even in the earliest days of the pandemic and the rollout of vaccines, the government paid for the shots completely, which is why authorities are adamant that Americans should reach out if they’re having issues. 

“There have been a number of glitches with billing codes [and] shipping of vaccines,” said Dr. Céline Gounder, a CBS News medical contributor. Xavier Becerra emphasized the fact that if you’re experiencing some sort of glitch to reach out to someone first before putting any money down.

“My sense is that these are glitches that will be addressed pretty quickly, but if not, please know, first and foremost, you should not have to put money out of pocket to get the Covid vaccine.”

Under federal law, insurance plans are required to cover Covid-19 vaccines at no cost to the individual through their providers. If there are no vaccination options within your insurer’s network, they are required to cover the service out of network without you paying anything. 

When the updated Covid-19 vaccine shots were approved by the Food and Drug Administration, the requirement for the shots to be fully covered in cost was immediate. In a letter to health insurers, Becerra outlined the details of the requirement: “I am writing to ask for continued partnership and also want to remind you of legal obligations for coverage of the vaccines…begin working on getting your systems ready.” 

Some pharmacies and doctors, however, have reported issues with some insurers not updating their billing systems properly for the vaccines, leading to some individuals being turned away from their appointments. 

“The guidance that CDC and CMS put out earlier about being able to start implementing, a good number of plans did not even follow that,” Mitchel Rotholz of the American Pharmacists Association said, as reported by CBS

Gounder explained on “CBS Morning” that “If you have private insurance — whether it’s private, Medicare, Medicaid — you should have your free vaccine at no cost to you.”

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“It’s covered by insurance. But because of these glitches, there have been some issues. You may want to wait until early to mid-October just for these things to get ironed out. If you do get your vaccine now, you may need to resubmit or appeal a denial, but you should get it for free.”

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“There needs to be some stronger enforcement to put that in place, unless we’re going to continue to face these obstructions,” Rotholz said.

Becerra said he urges insurers “to act as quickly as possible. In the meantime, I am urging consumers to reach out to their plans or issuers so that you can meet your obligations as easily as possible,” he said.

Locations with available vaccines can be found online at vaccines.gov through the “Bridge Access Program” which is run by the US Centers for Disease Control and Prevention. The site includes healthcare facilities and pharmacy locations backed by the federal government. 

“The Bridge Access Program is designed to get rid of patient barriers to COVID-19 vaccines. The burden of patient eligibility verification will be on our healthcare systems, not on patients,” the CDC said.