With COVID-19 numbers rising, and flu season around the corner, folks are eager to get their vaccinations. However, many patients were met with a hefty bill and a rocky start to the vaccine rollout.
The public distribution of an upgraded COVID vaccination during the Biden administration has reportedly been plagued by shipping issues and limitations in insurance coverage.
While Medicare, Medicaid, and most private health insurance plans are obligated to cover the total cost of the immunizations, some patients claim they were charged up to $190 per injection at pharmacies. In the past, the United States government bought COVID-19 vaccines from producers and distributed them gratis to all citizens.
Some individuals seeking the most recent COVID-19 vaccinations are encountering high demand, insurance issues, and supply delays nationwide. Since the CDC approved them for use in children six months and older, millions of newly developed vaccinations have shipped out.
However, some patients had to reschedule visits because their insurers hadn't changed the billing codes to include the immunizations. Others scheduled appointments only to have them postponed due to supply concerns.
"Some payers are still updating their systems and may be unable to cover the updated COVID-19 vaccines. If this happens, our pharmacy teams can help patients schedule an appointment for a later date," said Matt Blanchette, the Senior Manager of Retail Communications at CVS Pharmacy, to Healthnews.
Additionally, there may not be any local immunizations in specific locations. Since public and private health insurers are once again involved in the process, it is the first time that most individuals in the U.S. receive immunizations through the commercial sector.
Karyne Jones, President and CEO of the National Caucus and Center on Black Aging (NCBA), shared with Healthnews, "It's frustrating that consumers are experiencing these challenges, but we know that health plans and pharmacies are working on sorting out these issues quickly and hopefully will have them resolved very soon."
NCBA convenes the COVID-19 Vaccine Education and Equity Project (CVEEP), a coalition dedicated to ensuring that everyone in the U.S. can access vaccines.
"Our pharmacies began receiving the updated COVID-19 vaccines on Wednesday, 9/13, and have continued to receive inventory on a rolling basis. To identify if a specific location has received its delivery, please utilize our digital scheduler at CVS.com, which shows real-time availability."- Blanchette
Out-of-Pocket Vaccine Experience
Eric Allix Rogers, who lives in Chicago, told Healthnews he had to pay $155.99 at Walgreens to get his vaccination.
"I have insurance, but it did not cover the shot on the day I got it. I was in a hurry due to upcoming work travel, so I paid out of pocket. I had been warned several days before that the claims were not yet going through, and I went in prepared for the possibility of having to pay for it out of pocket."- Rogers
Rogers said that he did receive a warning from the pharmacy, but he said he was willing to pay anyway. He hopes to get a reimbursement from his health insurance.
"It will not deter me from getting future vaccines, but it is disappointing that a process was not in place to make this work quickly once the vaccine became available," he said.
Others have been reporting on their experience and sharing how much they had to shell out for a vaccination across social media.
CVS just turned my husband away from getting his COVID vaccine because they said Medicare didn’t cover it, which is a lie. I got mine at Walgreens which is a much better pharmacy. @cvspharmacyundefined Deb Messling (@debocrat) September 21, 2023
At most, flu vaccination might cost anywhere from $20 to $70 out of pocket. Nevertheless, the cost will change according to various flu vaccination types. Most insurance providers will pay for flu vaccine at pharmacies or urgent care centers, however.
Each year, the flu vaccination avoids millions of illnesses and medical visits connected to the flu. It has been demonstrated to lower the likelihood of needing to visit the doctor with the flu by 40% to 60% during seasons where the flu vaccine viruses are comparable to the circulating flu viruses.
When will the vaccine supply-chain shortages be resolved?
Although supply-chain issues seem to be easing and improving, they aren't totally fixed. Vaccine manufacturers claim that they've made enough vaccines but pharmacies are still waiting on shipments.
As a result, it could still be up to two weeks for all pharmacies like CVS and Walgreens to catch up to the backlog and fix these distribution issues.
As pharmacies pick up the slack of supply shortages and system updates, patients should check in with their health insurance before visiting a clinic. Jones suggested that consumers check in with their insurance plan and pharmacy before they go in for their vaccine. If they are charged, she recommends they contact their plan's customer service.
- NBC News. New Covid vaccine rollout hampered by canceled appointments, insurance issues.
- CDC. CDC Recommends Updated COVID-19 Vaccine for Fall/Winter Virus Season.
- CDC. CDC Vaccine Price List.
- Mira. How Much Does a Flu Shot Cost Without Insurance in 2023-2024?
- CDC. Vaccine Effectiveness: How Well Do Flu Vaccines Work?