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What to Know About Vaccines After 50
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Are COVID-19 Vaccines Still Free?

The federal government is no longer footing the bill for all coronavirus shots


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Pharmacies, clinics and other health care providers are now administering the newly approved COVID-19 vaccines. But will you need to pay for the shot yourself now that Uncle Sam is no longer covering the cost for everyone?

Probably not, though getting the shot for free isn’t as much of a no-brainer as it was during the height of the pandemic. Up to now, the cost of a COVID-19 vaccine wasn’t even discussed. From the time the first vaccines became available in late 2020, the federal government was footing the entire bill. It had bought hundreds of millions of doses, and Americans were able to get shots without paying a dime. 

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Now that the COVID-19 public health emergency is officially over, whether you have to pay out of pocket and how much will depend on what kind of health care coverage you have. The Centers for Disease Control and Prevention (CDC) recommended on Sept. 12 that everyone 6 months of age and older get the latest vaccine.

Here's how much you could expect to pay, if anything, depending on your insurance.

On Medicare or Medicaid? It’s paid for

For Medicare enrollees, the new COVID shots are free of charge to beneficiaries. This goes for whether you have original Medicare or are enrolled in a Medicare Advantage (MA) plan. COVID vaccines are covered under Part B, the part of Medicare that pays for doctor visits and other outpatient services.

But there is a caveat. If you are in an MA plan, you probably have a network of pharmacies and doctors that you have to use to get the maximum coverage. If you go out of network to get your COVID-19 vaccine, you may be subject to some cost sharing. How much will depend on your plan.

Medicaid, the federal-state program for people with low incomes, will cover the vaccine at no cost to enrollees.

Have private insurance? It’s probably paid for

“Virtually all private insurers will have to cover the updated COVID-19 vaccines at no cost,” says Jen Kates, senior vice president and director of global health and HIV policy for KFF, a nonpartisan health policy organization. 

Kates explains that the Affordable Care Act (ACA) mandates that these vaccines be covered as part of its preventive services requirements. And beyond that, the Coronavirus Aid, Relief, and Economic Security (CARES) Act strengthened that provision by requiring that private insurers cover COVID-19 vaccines within 15 days of their being recommended by the CDC.

As with Medicare Advantage plans, if your private insurance requires that you use an in-network provider or pharmacy to qualify for full coverage, and you go out of network to get the new shot, you may have to pay something out of pocket.

In addition, some insurance plans are not subject to ACA requirements, most notably short-term insurance plans that are also referred to as “skinny” plans because they provide limited coverage. If you have one of those skinny policies, your plan might not pay for the new vaccine. But see below: Help is on the way.

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Uninsured? Uncle Sam will pay for now

If you are one of the estimated 25 million to 30 million Americans without health insurance, the federal government has you covered — at least temporarily. 

A new CDC initiative, called the Bridge Access Program, will provide free COVID-19 vaccines to all Americans who either don’t have insurance or are underinsured. This would apply, for example, says Kates, to people with those skinny insurance plans. For now, this is a temporary fix. The bridge program is only scheduled to last through December 2024.

People who want to use the bridge program will soon be able to go to vaccines.gov and search for a pharmacy, health center or other medical provider that is participating in the program and get their free vaccine.

What’s the price of a COVID vaccine?

In deciding whether to recommend that everyone over 6 months of age get the new shot, the CDC’s Advisory Committee on Immunization Practices members asked representatives of the vaccine manufacturers for the list price of the new vaccines.

They were told that Moderna's product would cost $129 per dose, while Pfizer’s vaccine is priced at $120 per shot. Both were approved by the Food and Drug Administration (FDA) on Sept. 11. Novavax’s latest vaccine, which has not yet been cleared by the FDA, would be priced at $130 per dose.

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