The FDA is expected to approve new Covid shots soon, but only for adults 65 and older and people with underlying health conditions. The CDC may follow suit, limiting its recommendation to these groups. As a result, some insurers might not cover the vaccine for healthy individuals.
Under federal law, most health insurance plans must fully cover vaccines recommended by the CDC and ACIP. However, for those not in the high-risk group, coverage will depend on their insurance policy. Some may require no copay or full payment, while others may not provide coverage at all.
The cost of a Covid vaccine can range from $0 to $140, depending on the insurer. Experts warn that this change could lead to confusion and misinformation about who is eligible for the vaccine.
Despite the uncertainty, children and adults under 65 will still be able to receive the Covid vaccine. Insurance companies may choose to cover them off-label, but this decision will vary by insurer. The CDC’s list of high-risk conditions includes cancer, heart disease, and lung conditions.
Some insurers, such as Blue Cross and Blue Shield, have already announced that they will provide coverage for Covid vaccinations without copays. However, private plans, including Obamacare, may not implement changes until the next benefit year.
As a result, some individuals may be surprised with unexpected bills or uncovered costs if they receive a Covid shot before any potential policy changes take effect.
Source: https://www.nbcnews.com/health/health-news/-fall-covid-shots-may-come-copays-no-coverage-rcna226160