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Biden administration draws commitment from health insurers to cover COVID-19 shots

Health and Human Services Secretary Xavier Becerra receives an updated COVID-19 booster and a flu shot at a local CVS Pharmacy September 20, 2023 in Washington, DC. (Photo by Drew Angerer/Getty Images)

The Department of Health and Human Services (HHS) met with representatives from the health insurance industry on Wednesday, receiving commitments that the updated COVID-19 vaccines will be covered after reports arose of some people having to pay out-of-pocket for their immunizations.

HHS Secretary Xavier Becerra met with executives from Anthem, Blue Cross Blue Shield (BCBS), the Better Medicare Alliance, CareFirst, Cigna, Humana, and CVS Health, which owns Aetna as well as AHIP, the trade organization that represents the health insurance industry.

Shortly after the Centers for Disease Control and Prevention (CDC) approved the updated COVID-19 vaccines from Moderna and Pfizer, local reports began to crop up of people having to pay out-of-pocket — up to $200 — for their immunizations, despite the fact that those shots should have been completely covered by insurers.

AHIP alluded to the issue having to do with updating billing codes for the new vaccines. When receiving his own dose of the vaccine, Becerra said he was aware of this issue and his department had reached out to insurance companies.

The insurance companies on Wednesday apparently told Becerra that these technical issues with covering the vaccines have now been “largely if not completely” resolved.

In a letter to Becerra on Wednesday, AHIP, the Alliance of Community Health Plans, the Association for Community Affiliated Plans and BCBS stated, “You have our commitment that health insurers are fully covering the new COVID-19 shots, as required, with no cost sharing when consumers access them from a network provider or receive them through an out-of-network provider when in-network options are unavailable.”

“In collaboration with the Administration, our industry has been preparing for the new COVID-19 vaccine distribution system for months to facilitate patient access to this critical preventive service. These preparations allowed us to quickly resolve technical and coding issues as they arose,” they added.

The meeting also apparently led to BCBS adding Walgreens to its network for federal employees after HHS discussed the pharmacy chain not being in-network.

While the billing code issue led some to questions about whether the federal government had kept insurers appraised of the vaccines, HHS clarified on Wednesday that it had been meeting with these companies frequently over the past year.

The department also provided an update on the vaccinations in the U.S. Information on vaccination rates stopped being updated on the CDC’s website after the end of the public health emergency declaration.

According to HHS, more than 2 million people have been vaccinated so far and more than six million vaccines have been shipped to pharmacies. More than 8 million free at-home COVID tests, which the Biden administration made available once more last week, have been ordered as well.