The COVID-19 pandemic has plagued the US for the better part of 2020, and several vaccines are in development. With Moderna, Pfizer and AstraZeneca reporting positive results from their vaccines, it’s possible the FDA will approve an emergency use authorization soon.
Americans will have access to free COVID-19 vaccines once they become available — though some people may have to wait.
The US government will pay insurers to administer the vaccine swiftly.
Medicaid and Children’s Health Insurance Plans
Yes — for as long as the coronavirus is a public health emergency.
When the pandemic is no longer an emergency, states may evaluate cost-sharing policies and submit changes to the CMS.
What if I don’t have health insurance?
You can get the vaccine at no cost under the new legislation. The federal government set up the Provider Relief Fund to pay healthcare providers who vaccinate uninsured people.
The fund will be managed by the Health Resources and Services Administration, though we don’t know much more at this point.
What does “emergency use authorization” mean?
For a drug, device or vaccine to be approved by the FDA, it needs to undergo extensive research and testing — which typically takes a few years.
But the FDA can issue emergency use authorizations, which authorizes products for as long as the public health emergency lasts. Testing is less comprehensive for an authorization, and the product goes through the rigorous testing process once the emergency is over.
The coronavirus was declared a public health emergency on January 31, 2020. With infection rates increasing around the world, the emergency likely won’t be lifted any time soon.
Who will get the COVID-19 vaccine first?
Healthcare workers and nursing home residents should be prioritized, according to the CDC’s Advisory Committee on Immunization Practices — a panel made up of health and immunization experts. They met on December 1st to vote on how the COVID-19 vaccine will be distributed once approved.
“Healthcare settings in general, and long-term care settings in particular, can be high-risk locations for SARS-CoV-2 exposure and transmission,” the Advisory Committee said when explaining their decision.
“As of December 1, 2020, approximately 245,000 COVID-19 cases and 858 COVID-19-associated deaths had been reported among US healthcare personnel. Early protection of healthcare personnel is critical to preserve capacity to care for patients with COVID-19 or other illnesses.”
“Long-term care facility (LTCF) residents, because of their age, high rates of underlying medical conditions, and congregate living situation, are at high risk for infection and severe illness from COVID-19. As of November 15, 2020, approximately 500,000 COVID-19 cases and 70,000 associated deaths had been reported among residents of skilled nursing facilities, a subset of LTCFs serving residents with more complex medical needs.”
To give you an idea of the size of this group, approximately 21 million Americans work in healthcare settings such as hospitals and outpatient clinics, and there are 3 million people in nursing homes across the US.
If the CDC accepts the recommendations, that will become official guidance for federal and state officials. We will update this page when we have confirmation.
Thanks to new legislation, insurers and healthcare providers aren’t allowed to charge patients for the COVID-19 vaccine. Once it becomes available, it will be available at no cost to all Americans — including those on Medicare and Medicaid and the uninsured.
Yes. Health insurance companies cover vaccines recommended by the CDC’s Advisory Committee on Immunization Practices, and at no charge to patients under the ACA.
However, the ACA is limited to “immunizations for routine use” — meaning emergency vaccines aren’t always covered. That’s what makes the new legislation surrounding the COVID-19 vaccine unique.
It’s not clear. The CMS is working to increase reimbursement for any new COVID-19 treatments that are approved or authorized by the FDA — but we don’t know much more.
At the moment, insurers don’t have to cover COVID-19 treatment. Depending on your age and the severity of the case, this may involve respiratory therapy or hospitalization.
Yes. Under the Families First Coronavirus Response Act, private health insurers must cover diagnostic tests while the public health emergency is in place. They’re also covered by Original Medicare and Medicare Advantage plans, but some states have opted out of Medicaid eligibility.
Most health insurance plans don’t pay for antibody tests, which are designed to detect if you’ve previously had COVID-19.
Katia Iervasi is a staff writer who hails from Australia and now calls New York home. Her writing and analysis has been featured on sites like Forbes, Best Company and Financial Advisor around the world. Armed with a BA in Communication and a journalistic eye for detail, she navigates insurance and finance topics for Finder, so you can splash your cash smartly (and be a pro when the subject pops up at dinner parties).
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