Will Medicare Pay For A COVID-19 Vaccine? Coverage Plans Revealed

After President Donald Trump hinted a COVID-19 vaccine is coming soon, his administration is expected to make an announcement regarding Medicare and Medicaid recipient vaccination coverage this week.

Out-of-pocket costs for the vaccine will be covered under the two programs when it receives emergency authorization from the U.S. Food and Drug Administration, altering Medicare and Medicaid’s current policy, sources for Politico reported.

The announcement from the Trump administration is expected to come Tuesday or Wednesday from the Centers for Medicare and Medicaid Services (CMS).

CMS Administrator Seema Verma seemed to predict this news earlier this month, saying at the HLTH virtual conference, “I think we've figured out a path forward. It was very clear that Congress wants to make sure that Medicare beneficiaries have this vaccine and that there isn't any cost-sharing.”

Currently, COVID-19 tests are covered under Medicare Part B if they are administered by a laboratory, pharmacy, doctor, or hospital. Tests can also be administered at home, in some instances, without copayments, deductibles, or coinsurance being charged. Some “parking lot” test sites are also covered as well as COVID-19 antibody tests.

Medicaid also covers COVID-19 testing, along with private health insurance plans. Vice President Mike Pence made this announcement back in March as it was deemed an essential health benefit by the U.S. Department of Health and Human Services, CNBC reported.

It is unclear at this time how CMS plans on paying for the COVID-19 vaccine for the 120 million recipients that receive healthcare coverage under the government plans.

At least two COVID-19 vaccines are planned for emergency use authorization by the end of 2020, Politico said.