How much will the COVID-19 vaccine cost you?

Tuesday, December 15, 2020
SAN FRANCISCO (KGO) -- You have probably heard that the federal government will pay for the coronavirus vaccine for all of us. But what does that really mean? There is a difference between paying for the vaccine -- the medicine in a syringe -- and the syringe itself.

The Centers for Disease Control and Prevention's website's FAQ section says everyone gets the vaccine at "no cost," but keep reading deeper and you'll find this: "providers will be able to charge" for their services.
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What?

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Digging through government web pages, it appears health insurance companies will be required to pay for vaccine expenses picked up by the federal government.

Covered California keeps close track of these things.



"There is still a lot being decided at the federal level, but given what we have seen based on the decisions and actions at the federal level," says James Scullary, Covered California spokesperson. "We expected the vaccines will be covered for Covered California consumers without cost-sharing."

Nothing final, but it looks good.

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Now, let's turn our attention toward seniors.

A recent survey by Silver Sneakers, a leading senior health and wellness program, found costs are seen as a major barrier to getting the vaccine, with 6 in 10 seniors surveyed believing they will have to pay.



Richard Ashworth is president and CEO of Silver Sneakers' parent company, Tivity Health.

"One of the insights that worried me the most, is that when we asked them, 'What are some of the barriers that would prevent you from wanting to take the vaccine?' and cost was a big one," Ashworth said.

There's good news here: it appears Medicare will cover this vaccine like any other.

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That brings us to this concern as voiced by San Franciscan Eugene Duffy: "I'm wondering about the homeless and I know other folks just don't have insurance right now."



The CDC says the Department of Health and Human Services will pick up that cost at Medicare rates through the CARES Act's Providers Relief Fund.

Here is where you could get billed: some providers will not accept that rate or will decide against going through the hoops to get that money, which include:
  • Enrolling in the program

  • Checking patient eligibility

  • Submitting patient information

  • Submitting claims


It is possible your provider will opt-out and you will be billed -- not for the vaccine itself, but for everything surrounding it. So, it is important you check with your provider and insurance company so you know exactly what will be covered.
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