Federal Rules Protect People from Bills for the COVID-19 Vaccine

As the first doses of the new COVID-19 vaccine are delivered to health care workers and other early recipients, many Americans are eager to know not only when the vaccine will be available to them but also whether they will be able to get it at no cost.

The answer is that providers are not allowed to charge patients who get the vaccine, at least during the public health emergency, KFF experts write in a new issue brief. But it will be important to drive home that message to the public since some patients have been left with unexpected bills for COVID testing and treatment in spite of federal rules and programs, as well as voluntary efforts by insurers, designed to cover such costs.

Through Operation Warp Speed, the federal government has purchased hundreds of millions of doses of COVID-19 vaccines that are being distributed to providers at no cost. In turn, providers must agree to not charge for the vaccine itself. While providers can charge for the cost of administering the vaccine, private insurance and public programs will cover 100 percent of that cost during the public health emergency.

People who are uninsured also will not be charged for the vaccine. Providers who wish to be reimbursed for administering the vaccine must bill the federal government and cannot bill uninsured individuals. It will be important for the federal government to develop plans to strictly enforce these requirements to ensure that the public receives the vaccine for free as intended.

In the issue brief, KFF experts highlight the laws and regulations that are in place to ensure access to free COVID-19 vaccines for individuals regardless of their insurance status and explain how vaccine administration costs will be covered in private insurance, Medicare and Medicaid, and for the uninsured.

There will be many challenges convincing people to get the COVID-19 vaccine. Fear over unexpected costs need not be one of them.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.