Health Insurance Questions: COVID-19 Vaccine and Testing

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If you are confused about the COVID-19 vaccines, you aren’t alone. The news is constantly changing as new vaccines are being developed and distributed. As of the writing of this article, there are three types that are available or currently undergoing clinical trials. The three types are mRNA vaccines, protein subunit vaccines, and vector vaccines. Two of these require two doses to achieve the most protection from COVID-19. Pfizer’s vaccine is an mRNA vaccine with two shots spaced 21 days apart. Moderna’s is also a mRNA vaccine, but requires 28 days between shots.

Heath Insurance Questions: COVID-19 Vaccine and Testing

The cost for the COVID-19 vaccine will be nothing for most people during the public health emergency period, which is currently effective until April 21, 2021. This includes those 65+ who are covered by Medicare, as this was dictated by the CARES Act enacted in March 2020. The COVID-19 vaccine is covered under Part B just like other vaccines, including the influenza and pneumococcal vaccines. As for private health insurance, most are covering the COVID-19 vaccine without cost-sharing. There are some exceptions because grandfathered group health plans do not fall under the CARES Act, although many are stepping up and covering it anyway. Grandfathered plans do have to cover COVID-19 testing, however.

COVID-19 testing can be done as a viral test or an antibody (blood) test. The viral test tells you if you currently have COVID-19. The antibody test will tell you if you were previously infected. As for coverage for COVID-19 testing, there are many places in most communities where you can get the viral test for free. The price for the antibody test ranges from $25 to over $100 if you are not insured or covered by Medicaid or Medicare or if your doctor won’t prescribe it. Most insurance plans will cover it when it is medically necessary and prescribed by a doctor.

It takes just a quick phone call to find out what your insurance company covers in terms of COVID-19 testing and the vaccine. Some have gone public with their standing, such as Blue Cross Blue Shield’s commitment to waving cost-sharing for COVID-19 testing and treatment for commercial plans.

If you have questions about coverage for the COVID-19 vaccine or testing, reach out to us at Elite Benefits Group in Monroe, North Carolina. We can usually answer your question. or we can point you in the right direction based on the health insurance plan you have. Call today to learn more about individual health plans, group health insurance or life insurance.