Medicare, Private Plans to Cover Cost of Early COVID-19 Vaccine

COVID vaccine
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If a coronavirus vaccine is approved early, nearly all Americans — including those covered by Medicare, Medicaid or private health insurance — will not have to pay any costs when getting vaccinated, thanks to a recent rule change.

The Centers for Medicare and Medicaid Services just announced a rule change that will allow full coverage for people who get any vaccine that is approved early, under what is known as an emergency-use authorization.

That is an important change from standard rules, which typically only allow vaccines to be covered if they go through the standard approval process, CNBC reports. Because of the imminent and widespread danger posed by COVID-19, the process for vaccine approval is being fast-tracked.

As a result of the rule change, patients with Medicare or Medicaid can get the vaccine without having to pay any costs like coinsurance or deductibles.

CNBC reports that if everyone on Medicare received a COVID-19 vaccine, the total cost would be about $2.6 billion, according to figures from the federal Centers for Medicare & Medicaid Services, or CMS.

AARP reports that the federal government also is requiring private health insurance plans to cover COVID-19 vaccines without cost sharing, even if the person is getting the vaccine from an out-of-network provider. AARP says medical professionals will be reimbursed when they vaccinate people who do not have health insurance.

In an interview with AARP, CMS Administrator Seema Verma said the rule change “sends a message to the American people that this is not something that they need to worry about.”

Verma also told AARP that the federal government is taking steps to ensure that Americans will be quickly vaccinated in large numbers. Plans are underway to create a network of “mass immunizers” that will include pharmacies, schools, public health clinics and other nontraditional providers.

Several vaccines are currently being developed, with hopes that at least one could receive fast-track approval late this year or early in 2021.

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