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Get Paid for COVID-19 Vaccination Costs Not Covered by Insurance Under New HHS Program
By Amy Lynn Sorrel

Since physicians cannot bill patients for COVID-19 vaccine administration, a new federal program aims to fill in the gaps by covering the outstanding costs not covered by health insurance plans.

The Department of Health and Human Services (HHS) on Monday launched the COVID-19 Coverage Assitance Fund (CAF), which will pay physicians and other vaccine administrators at the new higher Medicare rates announced in March.

“On top of increasing reimbursement rates tied to administering the shots, we are closing the final payment gap that resulted as vaccines were administered to underinsured individuals. No health care provider should hesitate to deliver these critical vaccines to patients over reimbursement cost concerns,” HHS Secretary Xavier Becerra said in a news release.

The Centers for Disease Control and Prevention issued guidance in February stipulating that physicians and other vaccine administrators must administer COVID-19 vaccines regardless of patients’ ability to pay and at no out-of-pocket costs to patients. Physicians could, however, seek payment from a health plan or program that covers the patient’s COVID-19 vaccine administration fees.

“While the COVID-19 vaccines themselves are free to all adults in the US, providers incur other costs – from training to storage to staffing – when administering them. Typically, providers would bill either insurance plans or patients for these expenses,” HHS said.

CAF focuses on instances in which patients have insurance but those health plans either do not cover the COVID-19 vaccines or require patient cost-sharing.

CAF – which is funded under the CARES Act Provider Relief Fund and builds on the Health Resources and Services Administration COVID-19 Uninsured Program – will accept eligible claims dated on or after Dec. 14, 2020. Physicians must submit those claims electronically, and they are subject to available funding, HHS says.

Last Updated On

June 08, 2021

Originally Published On

May 04, 2021

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Amy Lynn Sorrel

Associate Vice President, Editorial Strategy & Programming
Division of Communications and Marketing

(512) 370-1384
amy.sorrel[at]texmed[dot]org  
Amy Sorrel

Amy Lynn Sorrel has covered health care policy for nearly 20 years. She got her start in Chicago after earning her master’s degree in journalism from Northwestern University and went on to cover health care as an award-winning writer for the American Medical Association, and as an associate editor and managing editor at TMA. Amy is also passionate about health in general as a cancer survivor, avid athlete, traveler, and cook. She grew up in California and now lives in Austin with her Aggie husband and daughter.

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