CMS to Pay for COVID-19 Booster Shots

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In a continued effort to ensure cost is not a barrier to vaccine access, on September 24, 2021, CMS announced that it will pay for Medicare beneficiaries’ COVID-19 booster doses without any cost sharing. Medicare beneficiaries currently pay nothing for COVID-19 vaccines or their administration, with no applicable copayment, coinsurance or deductible. This will now also include COVID-19 booster shots following FDA’s recent authorization of the Pfizer COVID-19 booster for high-risk populations.

In addition, COVID-19 booster shots will be covered for nearly all Medicaid and CHIP beneficiaries with no cost sharing. The American Rescue Plan Act of 2021 requires coverage of COVID-19 vaccines and administration for nearly all Medicaid and CHIP beneficiaries without cost sharing. This will now include COVID-19 boosters for eligible consumers of most commercial health insurance plans.

CMS’s press release can be accessed here. CMS’s COVID-19 provider toolkit can be accessed here, and CDC’s COVID-19 Vaccination Program Provider Requirements can be accessed here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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