Medicare will cover COVID-19 vaccines at no out-of-pocket cost

Medicare will cover COVID-19 vaccines approved by the Food and Drug Administration at no cost to beneficiaries, CMS said Wednesday.

CMS will pay for any coronavirus vaccine that receives an Emergency Use Authorization or licensed under a Biologics License Application. The interim final rule also implements parts of the CARES Act “to ensure swift coverage of a COVID-19 vaccine by most private health insurance plans without cost-sharing from both in and out-of-network providers during the course of the public health emergency,” CMS said in a statement.

“As Operation Warp Speed nears its goal of delivering the vaccine in record time, CMS is acting now to remove bureaucratic barriers while ensuring that states, providers and health plans have the information and direction they need to ensure broad vaccine access and coverage for all Americans,” CMS Administrator Seema Verma said in a statement.

The rule also allows hospitals to qualify for additional outlier payments when they treat patients with innovative new products approved or authorized to treat COVID-19 to reduce any losses they may experience from making these therapies available, even if they do not reach the current outlier threshold. It also allows providers to get reimbursed for outpatient services for COVID-19 treatments that occur outside of bundled arrangements, CMS said.

CMS is also mandating that providers post their prices for COVID-19 diagnostic testing online.


Tags: covid-19, pandemic

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