Is the COVID-19 Vaccine Free If You're Uninsured?

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Most health insurance plans in the United States will provide coverage for COVID-19 vaccines with no cost-sharing for members, which means that people will not have to pay for the vaccine or its administration. But, nearly 30 million Americans were uninsured in 2019, and that number has likely increased in 2020 as a result of the economic impact of the COVID-19 pandemic.

If you're in a situation where you don't have health coverage that will pay the cost of a COVID-19 vaccine, can you still get it at no cost? Probably, but you'll want to pay close attention to make sure you don't get a surprise bill for a vaccine you assumed would be free.

Vials of COVID-19 vaccines
MarsBars / Getty Images

Uninsured Children

Once a COVID-19 vaccine is approved for use in children—and assuming the Centers for Disease Control and Prevention (CDC) includes it in the Vaccines for Children (VFC) program—uninsured children will be able to receive it free-of-charge from providers who participate in the VFC program.

The VFC program is a federal program that provides funding for vaccines to people under 19 who are Medicaid-eligible, uninsured, underinsured, American Indian, or an Alaskan native.

Consumer Warning

Be aware that while the vaccine is provided free of charge through the VFC program, there may be fees associated with the office visit. Even so, the VFC provider cannot refuse to administer the shot if a family is unable to pay. In cases like these, the fees are often waived.

The VFC program is specifically designed to ensure that children have access to vaccines even if their family doesn't have the means to cover the cost. Most pediatricians in the United States are providers for the VFC program.

Uninsured Adults

There is no safety-net program that guarantees access to vaccines for uninsured adults—and adults are more likely to be uninsured than children. However, the government has provided funding to reimburse medical providers who administer COVID-19 vaccines to uninsured adults.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA), both of which were enacted in the spring of 2020, provided a total of $175 billion in federal funding for a Provider Relief Fund.

The fund, which is operated by the Health Resources and Services Administration (HRSA), is being used to provide financial assistance to medical providers who participate in the Medicare and/or Medicaid programs.

A large portion of the fund is earmarked to reimburse medical providers for the cost of vaccinating uninsured individuals. While the federal government is tasked with providing the vaccine to states at no cost, the Provider Relief Fund is designed to reimburse providers for the cost of administering the vaccine.

Even so, the fund will likely be depleted as COVID-19 vaccinations are expanded through 2021. If this occurs, Congress will need to authorize further funding to ensure that these costs remain covered and uninsured people can be vaccinated.

Consumer Warning

The term "uninsured" can apply to people who have types of coverage that don't technically count as health insurance, such as a fixed indemnity plan or healthcare sharing ministry plan. If your health plan doesn't cover the cost of the COVID-19 vaccine, it may be because the plan isn't technically health insurance.

Challenges and Response

Since the early days of the pandemic, medical providers have been able to apply for reimbursement through the Provider Relief Fund for the cost of COVID-19 testing and treatment for uninsured individuals. With that said, they are not required do to so, and some have opted to bill the patient directly instead.

There are concerns that the same could happen with the cost of COVID-19 vaccination even if the vaccine itself is free. This could make uninsured Americans hesitant to seek vaccination if there is any chance they have to pay.

This leaves it up to you, as the consumer, to ask whether there are any fees associated with the administration of the vaccine. If there are, you may want to find a provider near you who participates in the Provider Relief Fund.

One way to do so is to contact your local health department or use the online locator offered by the U.S. Department of Health and Human Services (HHS), which searches providers based on your zip code.

In the end, if a provider receives reimbursement from the Provider Relief Fund for services related to COVID-19, they are not allowed to balance bill the patient and must accept the reimbursement as payment in full.

What to Do If You Are Billed

If you receive a balance-due bill for your vaccination after a portion of the bill has been paid by the Provider Relief Fund, the first thing you need to do is contact the provider. Unless you received additional services unrelated to COVID-19, there should be no charges of any sort.

On the other hand, if the provider doesn't obtain reimbursement from the Provider Relief Fund, the patient may be responsible for the entire bill. So again, it's important to ask up front whether there are any changes related to the vaccination and if the provider does in fact access the Provider Relief Fund.

If you believe you are being inappropriately billed, call your state Department of Health to issue a consumer complaint.

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Article Sources
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  1. Kaiser Family Foundation. Key facts about the uninsured population. Updated November 6, 2020.

  2. Centers for Disease Control and Prevention. About VFC. Updated February 18, 2016.

  3. Shen AK, Hughes IV R, DeWald E, Rosenbaum S, Pisani A, Orenstein W. Ensuring equitable access to Covid-19 vaccines in the US: Current system challenges and opportunitiesHealth Affairs. 2021;40(1):62-69. doi:10.1377/hlthaff.2020.01554

  4. Health Resources and Services Administration. COVID-19 claims reimbursement to health care providers and facilities for testing, treatment, and vaccine administration for the uninsured. Updated November 2020.

  5. U.S. Department of Health and Human Services. Provider relief fund general information (FAQs). Updated February 25, 2021.

  6. U.S. Department of Health and Human Services. Answers to National Governors Association questions on vaccine distribution and planning.

  7. USC-Brookings Schaeffer on Health Policy. The laws governing COVID-19 test payment and how to improve them. Updated July 13, 2020.

  8. U.S. Department of Health and Human Services. CARES Act Provider Relief Fund: For patients. Updated October 5, 2020.