Navigating Insurance Coverage for Updated COVID-19 Vaccines: What You Need to Know

The FDA has approved and authorized updated COVID-19 vaccines from Pfizer and Moderna, marking the transition of COVID-19 vaccines to the commercial market. The commercial price for these vaccines is significantly higher than what the federal government paid. However, under the Affordable Care Act and laws passed during the pandemic, COVID-19 vaccines will continue to be free for most individuals with private and public insurance coverage. Uninsured adults have no guarantee of free vaccines, but the Biden administration has proposed a mandatory Vaccines for Adults Program. Medicaid covers ACIP-recommended vaccines for adults with no cost-sharing permanently, while Medicaid covers ACIP-recommended vaccines for children at no cost through the Vaccines for Children Program. Medicare also requires no cost-sharing for COVID-19 vaccines.