The rollout of the new COVID-19 vaccines in New York has faced obstacles in recent days due to delays in health insurance coverage for the shots. Many New Yorkers who attempted to receive the vaccine discovered that they either had to pay out of pocket or reschedule their appointment when they learned that their health coverage did not include the vaccine. CVS Health and some health plans have confirmed this issue.
However, health plans have assured the public that the coverage problem is being addressed, and the new vaccines will be available without costs to consumers starting this week. Federal programs are covering the cost of the vaccine for the uninsured.
This setback comes at a time when there are concerns about limited uptake of the COVID-19 vaccines due to pandemic fatigue and anti-vaccine misinformation. The new vaccines have been proven effective against severe illness from all COVID variants currently spreading. So far, only 15% of New Yorkers have received a booster dose of the previous vaccine.
Previously, earlier versions of the COVID-19 vaccines were offered free of charge because the federal government used taxpayer dollars to purchase and distribute the vaccine. However, the federal pandemic emergency declaration ended, and vaccine funding was cut off. Going forward, health insurance companies and government health programs such as Medicaid and Medicare are expected to cover the cost of COVID vaccines.
In New York, the necessary computer coding for health insurers to cover the new COVID vaccines was made available late last week, resulting in some rescheduling of vaccine appointments. However, from now on, all health plans in New York should cover the new COVID vaccines as preventive services without any cost sharing for consumers.
The state Department of Health has recognized that some consumers were incorrectly informed that their insurance did not cover the cost of the vaccine. The spokesperson for the department encouraged these individuals to contact their insurers to request reimbursement.
Uninsured individuals or those whose insurance does not cover the updated vaccine can still receive the vaccine for free through community health centers, local health departments, tribal health departments, territorial health departments, and participating pharmacies in the HHS’ Bridge Access Program.
The issue with health coverage and the new COVID-19 vaccine arose due to an incorrect timeline communicated by the federal Centers for Disease Control and Prevention (CDC) to health plans. Empire BlueCross BlueShield, one of the health plans affected by the situation, stated that some members’ claims were rejected last week because pharmacies had access to the new vaccine earlier than anticipated. The claims are being re-processed, and members will receive the vaccine with no copay.
New Yorkers can find vaccination providers in their community by searching online through vaccines.gov or calling the federal vaccine hotline.
Sources: CVS Health, New York Health Plan Association, Empire BlueCross BlueShield, New York State Department of Health, Centers for Disease Control and Prevention
