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COVID Vaccine Won’t Cost Medicare, Medicaid Patients a Penny

Posted on Thursday, October 29, 2020
by Outside Contributor

Medicare and Medicaid beneficiaries will pay no out-of-pocket costs for Covid-19 vaccines under a plan announced Wednesday by the Trump administration.

An interim final rule from the Centers for Medicare & Medicaid Services allows both programs to cover the full cost of the vaccines—even those that receive emergency use authorization by the Food and Drug Administration.

Current rules don’t allow Medicare to cover drugs and vaccines authorized under the emergency use designation, which permits the FDA commissioner to OK the use of unapproved medical products in an emergency when no adequate, approved alternatives are available.

The new rule assures that Medicare will pay $17 for first the first vaccine dose and $28 for second, CMS administrator Seema Verma said in a call with reporters on Wednesday evening. If all 62 million Medicare beneficiaries were vaccinated, it would cost the program about $2.6 billion, Verma said.

Verma said the new rule is a “crucial plank” in the Trump administration’s “comprehensive strategy to ensure broad vaccine access and coverage for all Americans and to guarantee that seniors are prioritized for new Covid treatments and therapeutics.”

In addition, the rule assures that 68 million Medicaid recipients and youngsters in the Children’s Health Insurance Program will also be covered cost-free. People without insurance would have their vaccine costs covered by funds from the CARES Act provider relief fund, Verma said.

Under the new rule, Medicare will also pay an additional 65% of the costs for hospitals to provide innovative new Covid-19 therapies, Verma said. The rule also requires providers to post their prices for Covid-19 diagnostic tests online. Those who don’t could face fines.

Officials hope to have an available vaccine by the end of the year, Verma said. The CMS is working with the American Medical Association to release specific billing codes for each vaccine.

Currently no COVID-19 vaccines have been authorized or approved by the FDA nor recommended for use by the CDC’s Advisory Committee on Immunization Practices. But several companies working on a vaccine are expected to seek emergency use authorization for their product in the coming weeks.

Officials hope to have an available vaccine by the end of the year, Verma said. The CMS is working with the American Medical Association to release specific billing codes for each vaccine.

The administration recently struck a deal for CVS and Walgreens pharmacies to provide the vaccine to residents and staff at nursing homes and other long-term care facilities.

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Rexford O Ames
Rexford O Ames
3 years ago

I’m a senior. or think I am at 77 years of age. I am a bit concerned,that many seniors ,that do not reside in a Long Term facility are a nursing establishment will get the information and in many cases, Fear that the cost would be well out of their reach. Knowledge is indeed power however, Many seniors have enough on their lives just to exist. Many are terrified because the only information they ever get is: Gossip or watch CNN and have no, idea of the Bias behavior of the New;s Elite!

3 years ago

This is great news that Fed is going to furnish vaccine at no cost. I do not know if it is just me, but I get flu shot at Walmart & Medicare has paid the full cost the last 3 years. Before going on Medicare, I used to pay $30-50 for the shot & my insurance did not cover flu shots.

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