New COVID-19 Vaccine Rollout Hits Hurdles

The new COVID-19 vaccine rollout is off to a rocky start, with reports emerging of insured Americans being billed nearly $200 for the shot, which received FDA approval last week.

The latest vaccines are formulated to protect against new variants of the coronavirus and are recommended for people older than six months.

Anyone with private health insurance, Medicare, or Medicaid should be able to get the new COVID vaccines for free. But that's not always happening, according to published reports and social media complaints.

CBS News reported Tuesday that the vaccines have new billing codes and health insurers have not finished updating their plans to cover them, leading to erroneous charges for those looking to get vaccinated this first week.

Leading health insurance providers Blue Cross Blue Shield, Aetna, and Kaiser Permanente told The Hill they plan to cover the new COVID-19 shots as routine vaccines.

"Health insurance providers are working with the federal government and pharmacy and provider partners to ensure that everyone has access to ACIP-recommended vaccines, without cost sharing," health insurance trade association AHIP said in a statement to The Hill. "The new vaccine formulations mark the first time that the COVID-19 vaccines are available without being purchased/distributed by the federal government."

Health and Human Services Secretary Xavier Becerra reportedly received his COVID-19 booster at a Washington, D.C., CVS Pharmacy on Wednesday to encourage others to get theirs and promote the availability of the shots at pharmacies.

Becerra addressed the reports of insured people having to pay out-of-pocket for the shots while speaking to reporters, saying that any claims of insurance companies not covering them are "not correct."

"Please make sure you're talking to your insurance company because you should be covered by law," Becerra said. "If you are insured, you are covered for COVID. If you are on Medicare, you are covered. If you are on Medicaid, you are covered and if you don't have insurance — through this Bridge Access program — you are covered."

The Biden administration's Bridge Access Program will distribute vaccines for the uninsured through community health centers, local health departments, and pharmacies.

The secretary also encouraged customers with health insurance to check with their pharmacists to clear up any confusion.

"We've contacted the insurers and contacted the pharmacists and we're working with them to make sure everyone understands how this works," Becerra said.

Community health centers and local health departments are adapting to this new phase of COVID-19 response that does not include the federal funds they relied on during the pandemic to get people vaccinated.

Lori Freeman, CEO of the National Association of County and City Health Officials (NACCHO), told The Hill that health centers don't have the supply or the resources that they had previously.

"There will be about 6 million vaccines available and those initial vaccines are targeted towards the uninsured and underinsured folks through what is called the Bridge Program," Freeman said. "Three million will be available to state and local health departments through federally-qualified health centers and through the regional community health centers. And so there's going to be less vaccines and there are about 25 million total uninsured people in the country right now. So you can easily do the math."

Becerra said the federal Centers for Disease Control and Prevention (CDC) will pay similar per vaccine dose price as it did previously. According to The Hill, the federal government paid approximately $20 per dose for the first round of COVID-19 vaccines.

With the updated shots from Pfizer and Moderna being priced at $120 and $129, respectively, many health departments may not be able to afford the newer formulations, even with reimbursements, Freeman said.

"Some of the challenges we're seeing specifically with the local health departments' involvement are that there are some billing issues with the vaccine in that the reimbursement available to local health departments is less than the cost of the vaccine," Freeman said, noting one reimbursement rate is $65 for every $120 dose.