Employer Q&A Specific to COVID-19 Vaccines

Yes, we’ll cover the COVID-19 vaccine*. However, initially, the federal government will be purchasing vaccine doses. Providers are not allowed to charge an individual or a plan for the vaccine when it’s provided by the federal government. Once the government stops supplying the vaccine, plans will be requried to cover the cost as they do any other preventive service.

The CARES Act requires that group health plans (and individual health insurance plans) include coronavirus preventive services, including COVID-19 immunizations, as preventive services to be covered without member cost-share.

*Those under self-funded grandfathered plans that don’t have the Affordable Care Act 100% preventive coverage can speak to their account executive about how their plan will cover the vaccine and vaccine administration.

We don’t have a date for how long the federally purchased vaccines will be distributed. We’ll keep you updated as we learn more.

Yes. Plans must cover both the vaccine and the administration charge at 100%, just as they do other ACA preventive services*. While the vaccine cost will be covered by the federal government initially, plans will cover the administration cost.

*Those under self-funded grandfathered plans that don’t have the Affordable Care Act 100% preventive coverage can speak to their account executive about how their plan will cover the vaccine and vaccine administration.

Vaccine distribution will begin when the FDA issues Emergency Use Authorization (EUA) for the vaccines.

Because of limited supply, vaccine doses will be distributed to certain segments of the population in a phased approach. The first phase will include the highest-risk populations, like health care workers, first responders and seniors in care settings. Additional segments of the population will be added as the supply increases. Once there is sufficient supply, anyone who wants a vaccine will be able to get one.

Note that some vaccines may require two doses spaced apart in order to be effective. When vaccines are available, members should work closely with their health care providers to determine if and when they should get the vaccine.

You can also find answers to many of your vaccine questions through the CDC.

Yes.

We currently have no plans to offer drive-thru COVID vaccine clinics. At first, vaccine supplies will be limited. As vaccine supply grows, major retail chains and clinics will offer the vaccine on a wide scale. Additionally, the first vaccines approved need two doses to be effective, making follow-up drive-thru clinics logistically challenging.