Vaccine for COVID-19 may be free, but you could still see a bill. Here’s what we know

Once a coronavirus vaccine arrives, you won’t have to pay to receive it. The federal government is shouldering much of the cost in distributing the vaccine, and the Centers for Medicare and Medicaid Services is taking further steps to make sure all Americans have access to the vaccine at no cost once it’s available, the government organization said in a blog post. 

However, that doesn’t necessarily mean you won’t see a bill. Some providers may still charge a fee for administering the shot or infusion, depending on which company’s vaccine you use — there are several different formulations that could be available at once. Fortunately, federal regulations should be able to cap the amount you might be charged, as part of an effort to make the vaccine affordable to everyone.

Pfizer and Moderna have developed vaccine candidates they claim are 95% effective, and on Monday, Moderna applied for FDA emergency approval — new data shows the vaccine was 100 percent effective at preventing severe disease from the coronavirus. The first small batches could arrive Dec. 21, if approved by the Food and Drug Administration. (Here’s who will get the COVID-19 vaccine first.) The vaccines could help put an end to the COVID pandemic by slowing the spread of the coronavirus. While we won’t know all the details until immunizations begin, here’s what we know about how much you could be charged and how you might be able to appeal a medical bill for a coronavirus vaccine.

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How much will the coronavirus vaccine cost?

The COVID-19 vaccine itself will be free to all Americans, as noted by the CMS. The government organization also said it plans to make sure you can reimburse any FDA-approved coronavirus treatments you’re charged for. However, providers will be able to bill you an administrative fee for giving the shot to patients, according to the Centers for Disease Control and Prevention.

This would be similar to paying a charge when you visit the doctor’s office, or for specialized vaccine delivery, such as infusion, a process in which a substance — like medication, a chemotherapy drug or hydration — enters the bloodstream intravenously.

If you don’t have insurance, the medical provider you used should be reimbursed for any COVID-19 treatment you receive through the CARES Act Provider Relief Fund, at no cost to you. 

What if I receive a bill for my coronavirus vaccine?

If you receive a bill for your COVID-19 vaccine, you may need to file a claim with your insurance company since they’re required to cover approved preventive care under the Affordable Care Act. 

If you don’t have insurance and receive a bill, regulations state that the doctors will be able to get paid through the Health Resources and Services Administration’s Provider Relief Fund, according to the CDC, so you’ll need to contact the clinic or hospital where you received the immunization. There may be certain exceptions that apply.

If you receive a bill for administration fees, it’s still unclear whether or not those will be covered in full. It’s a good idea to contact your local provider or health insurance company for more details on whether you’ll be charged additional fees before receiving a vaccine. It might be that you have more than one option for immunization, including finding a medical provider that would give you the vaccine free of charge, or offer a more straightforward approach to reimbursement if you’re charged. 

Who will get the COVID-19 vaccine first?

Once a coronavirus vaccine is ready to be distributed to the public, here’s a likely order for who may receive it first. 

1. Health care workers

2. Essential workers

3. People with underlying medical conditions

4. Older adults

5. Everyone else

Note that each state may have its own priorities for which group could be first in line for the immunization. For example, California has published a draft of its coronavirus vaccine distribution plan (PDF). 

For more information, here’s what we know about the vaccine candidates right now and Biden’s plan to fight COVID-19. Also, coronavirus mRNA vaccines won’t just end the pandemic. They could change vaccines forever.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.