Title: Issues Arise with Billing and Coverage for COVID-19 Vaccines, Americans Urged to Contact Insurance Providers
Subtitle: Hurdles in Vaccination Coverage Should Be Temporary
Date: [Insert Date]
Federal health authorities are urging Americans who have encountered difficulties in obtaining their free COVID-19 vaccine shots to reach out to their insurance providers. Despite programs and requirements in place to ensure no out-of-pocket costs for vaccines, some individuals have reported issues obtaining the vaccine for free.
Earlier during the pandemic, COVID-19 vaccines and boosters were fully covered by the federal government. However, this year’s commercial rollout of vaccines from Moderna and Pfizer has faced glitches, leading to hurdles in coverage.
According to Dr. Céline Gounder, CBS News medical contributor and editor-at-large for public health at KFF Health News, “There have been a number of glitches with billing codes [and] shipping of vaccines.” The issues have caused confusion and inconvenience for some individuals seeking vaccination.
Officials have assured the public that these hurdles should be temporary and are currently being addressed by insurers and vaccinators working to rectify the problems in billing systems.
Health and Human Services Secretary Xavier Becerra emphasized that individuals should not have to pay out-of-pocket for the COVID-19 vaccine. He stated on September 20, “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 for individuals through providers within their insurer’s network. If no vaccinators within the network can offer the shots, insurers are obligated to cover out-of-network services without cost sharing.
Dr. Gounder advised individuals with private insurance, Medicare, or Medicaid, saying, “You should have your free vaccine at no cost to you. 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.”
For uninsured Americans, free COVID-19 shots are available through the federal “Bridge Access Program” administered by the Centers for Disease Control and Prevention (CDC). Locations offering shots under this program can be found online through Vaccines.gov and include health centers supported by the federal government, local health department vaccinators, and select retail pharmacy locations such as Walgreens and CVS.
The Bridge Access Program aims to eliminate barriers to COVID-19 vaccination for uninsured individuals. Vaccinators in the program are expected to administer shots at no cost, with payment coming from the federal government. Patients should not be required to prove their lack of health insurance, as the burden of eligibility verification lies with healthcare systems.
Despite the challenges, federal health officials have been actively encouraging insurance providers to ready their systems ahead of the fall vaccine rollout. However, some pharmacies and doctors have reported issues with certain insurers not updating their billing systems for the shots, resulting in individuals being turned away from their appointments.
Mitchel Rotholz of the American Pharmacists Association highlighted the need for stronger enforcement to minimize such obstructions. Similar challenges have been observed with insurance coverage and availability for other newly introduced vaccines this year.
Health and Human Services Secretary Xavier Becerra has urged insurers to act promptly and address the issues. In the meantime, individuals are advised to contact their plans or insurers for assistance with meeting their vaccination obligations.
The authorities remain optimistic that the coverage and billing glitches will be resolved expeditiously to ensure smooth access to free COVID-19 vaccines for all eligible individuals.
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