On Jan. 30, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations on May 11, 2023.

Vaccines

What’s changing: Nothing. The availability, access, and costs of COVID-19 vaccines, including boosters, are determined by the supply of federally purchased vaccines, not the public health emergency.

What’s the same: As long as federally purchased vaccines last, COVID-19 vaccines will remain free to all people, regardless of insurance coverage. Providers of federally purchased vaccines are not allowed to charge patients or deny vaccines based on the recipient’s coverage or network status.

Although a federal rule temporarily required private insurers to reimburse out-of-network providers for vaccine administration during the public health emergency, vaccine access will be unaffected by insurers ending these payments, as long as federal supplies last, because vaccine providers are not allowed to deny anyone a federally purchased vaccine based on the recipient’s coverage or network status and must not charge any out-of-pocket costs.

Due to the Affordable Care Act and other recent legislation, even after the federal supply of vaccines is gone, vaccines will continue to be free of charge to the vast majority of people with private and public insurance. However, costs may become a barrier for uninsured and underinsured adults when federally purchased doses are depleted, and privately insured people may then need to confirm their provider is in-network.

Importantly, the Food and Drug Administration (FDA)’s emergency use authorizations for COVID-19 vaccines (and treatments and tests) will remain in effect, as they are tied to a separate emergency declaration, not the public health emergency that ends in May.

Have any questions regarding this notice? Don’t hesitate to contact your Total Benefit Solutions health insurance specialists today at (215)355-2121.