COVID-19 vaccines must be covered at no cost, CMS says

October 28, 2020 / Susan Morse, Managing Editor

The Centers for Medicare and Medicaid Services is mandating that all Americans have access to a COVID-19 vaccine, when it becomes available, at no out-of-pocket cost. 

The agency’s interim final rule makes clear that private insurers must cover the vaccine at no charge to beneficiaries. Insurers are prohibited from charging administration costs of the vaccine, CMS Administrator Seema Verma said Wednesday.

“Balance billing is strictly prohibited,” she said.

Medicare Advantage beneficiaries also pay nothing for COVID-19 vaccines and their copayment/coinsurance and deductible are waived.

Private insurers must cover the vaccine without cost sharing from both in and out-of-network providers during the course of the public health emergency.

The federal government is paying for the actual cost of the vaccine.


Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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