(CNN)The Centers for Medicare and Medicaid Services said it will pay for any Covid-19 vaccine that is authorized or approved by the US Food and Drug Administration to allow for “broad vaccine access and coverage for all Americans.”
The agency also announced it will help cover a larger portion of the cost of new Covid-19 treatments that may be coming down the pipeline for Medicare recipients.
“There are several vaccines in Phase 3 trials, production and distribution plans are well underway, and CMS is doing its part by laying the essential groundwork for coverage and payment when a vaccine does arise. It’ll be widely available and accessible to seniors and every American,” CMS administrator Seema Verma said during a briefing Wednesday.
She said that while the federal government is paying for the vaccine, insurers including Medicare, Medicaid and private plans must cover the cost of administering it.
For Medicare recipients, any future vaccine would be covered by Medicare Part B as a preventative vaccine at no cost to beneficiaries. Medicare Part B covers doctor visits and outpatient services such as lab tests, diagnostic screenings and medical equipment.
“The rule removes any existing ambiguity surrounding Medicare’s coverage of the Covid-19 vaccine and allows us to focus on the paramount goal of ensuring that all of Medicare’s 62 million beneficiaries, including those enrolled in a Medicare Advantage plan, can receive the vaccine at their provider, their choice, again, at no cost,” said Verma.
She estimated that if “literally every senior got immunized,” it would cost “likely around $2.6 billion — that’s if everybody got vaccinated in the Medicare program.”
The new CMS rule requires most private health insurance plans, including individual health insurance and employer health plans — representing about 200 million Americans, according to Verma — to provide both in-network and out-of-network coverage of the vaccine, at no cost to their members.
The agency said that as a condition of receiving free Covid-19 vaccines from the federal government, providers may not charge people for administration of the vaccine…Read more>>