The federal government promises the COVID-19 vaccine will be free for most people. So, the NBC 5 Responds team dug deeper to find out who, if anyone, should expect to pay to get the vaccine.
The question comes after the federal government promised COVID-19 testing would be free, yet some North Texans still reported upfront fees and surprise bills last year.
This time, healthcare advocates say people should receive the COVID-19 vaccine without any out-of-pocket costs.
“Congress and the administration took to heart the rules that they tried to pass to make COVID testing free. And they were a little more careful and a little more airtight when it comes to the vaccines,” said Karen Pollitz – a senior fellow on health reform and private insurance with the Kaiser Family Foundation.
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Pollitz explains taxpayers are already purchasing doses to cover the costs in the immediate future – during the public health emergency.
“The first several hundred million doses of vaccine have already been paid for by the federal government. No one is supposed to be billing you for the vaccine if the federal government already paid for it,” said Pollitz.
Providers could charge an administration fee to cover the cost of storing the vaccine and the cost of a healthcare professional to administer the shots. However, surprise billing or balance billing isn’t allowed. Patients should not have to worry about going to an in-network provider.
Pollitz said people shouldn’t expect any cost-sharing measures – that means they don’t have to meet their deductible or fork over a co-pay for the vaccine.
The Centers for Medicare and Medicare Services also says the vaccine will be free. Additionally, the government set aside money to cover the uninsured.
Bottom line: if you get a bill, ask questions before you pay a provider.
“They might ask you for your insurance card so they can bill your insurance, but they shouldn't send you a separate bill for any additional amount,” said Pollitz.
Although the vaccine isn’t widely available to everyone yet, healthcare advocates explain it’s important to understand your rights so you won’t delay when a vaccine is available to you.
“If you're not sure, you might hesitate and if they run out of vaccine, it's even harder to sort of get back in line,” said Eagan Kemp, healthcare policy advocate with Public Citizen.
Kemp said you can check with your employer (if you get insurance through work) and your health coverage provider. If you are part of a health share ministry or get short-term health plan benefits, check with your administrators ahead of time.
Kemp explains there’s room for error – especially if a provider isn’t clear on the rules.
“It doesn't hurt to find out as much as you can,” said Kemp. “Once, whatever tier you're actually in, you're ready, you have the information.”
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*Map locations are approximate, central locations for the city and are not meant to indicate where actual infected people live.
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