Government says insurers must cover cost of COVID-19 shots


Insurers across the country are being reminded of their legal obligation to cover the cost of the new COVID-19 vaccine, as the federal government is no longer picking up the tab for the shots.

Amid reports of some insured Americans being denied coverage or being charged more than $200 for updated shots, U.S. Health and Human Services Secretary Xavier Becerra has issued a public statement to the “health care payer community.”

“With thousands of claims denied each day, we are losing opportunities to save lives together,” Becerra told payers in a statement posted Friday. ,

Becerra said reports of problems with insurance coverage began the same week that the new shots became available to everyone 6 months and older, despite more than a year of efforts to “ensure a smooth transition” from federal government distribution of the vaccine. Got green signal for.

He noted that payers have been repeatedly told about “the need to cover the updated COVID-19 vaccines from Pfizer and Moderna without cost sharing for most plans and issuers” who are scheduled to receive shots two weeks early. It came into effect upon approval.

Becerra said, “Unfortunately, some consumers are facing denials of insurance coverage when seeking updated COVID-19 vaccines, and I am writing to request continued partnership and to update you on coverage of the vaccines.” “Want to remind you of your legal obligations.”

“For every 10,000 vaccinations given to people over the age of 65 last winter, about 40 prevented hospitalization,” the secretary said, citing the Centers for Disease Control and Prevention.

The CDC’s COVID-19 “severity indicator” continues to rise, with the number of hospitalizations nationwide rising nearly 8% to more than 20,500 during the week ending September 9, and ending September 16 Deaths have increased to 12.5% ​​in the week.

The Utah Department of Health and Human Services said there were seven new deaths from COVID-19 in the state during the week ending last Thursday. This is the highest number of weekly deaths from the virus since nine people died in May.

Despite what is being seen as a “dramatic” surge in COVID-19, sales of the new shots were already expected to be tough as only 17% of Americans have rolled up their sleeves for the last vaccine update, a booster dose a Has been released more than years ago.

The latest shots targeting the new variant of the virus were approved by the U.S. Food and Drug Administration on Sept. 11 and by the CDC a day later, and were expected to be available by the end of that week.

But the vaccine rollout, for the first time since the federal government ended the national pandemic emergency, has been anything but smooth. There have been issues with supply as well as insurance coverage.

Han Kim, a professor of public health at Westminster University in Salt Lake City, recently told the Deseret News that the situation is desperate, but Utahns still have “a very easy way” to protect themselves from COVID-19. “should be taken advantage of.

“Wait a week or two until all this stuff settles down,” the professor advised. “I think the more people get vaccinated, the less surges we’ll see this fall and winter.”



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