How will the COVID19 Vaccine be covered? No Balance Billing Permitted

The Public Health Emergency (PHE) surrounding the Coronavirus Disease 2019 (COVID-19) pandemic extended the Public Health Emergency
declaration for another 90 days. This is the fourth time HHS has extended the PHE, the last time was October 2,
2020.

The vaccine itself will be paid for through funding authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, but administration of the
vaccine by a provider will be paid for by the payer.

Consumers enrolled in non-grandfathered group or individual health insurance coverage will be able to receive the vaccine and its administration free of charge from a network provider, and during the COVID-19 PHE, will also be able to receive the vaccine and its administration free of charge from an out-of-network provider. Providers are prohibited by agreement with the U.S. Government from billing patients for the vaccine or its administration, including balance billing during the PHE.

 

For more information on Public Health Emergency (PHE); https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-07Jan2021.aspx
For more information on U.S. Department of Health & Human Services (HHS); https://www.hhs.gov/coronavirus/index.html
For more information on Centers for Medicare and Medicaid Services (CMS); https://www.cms.gov/covidvax

We hope you found this information useful.   We felt this information was important to share with everyone.   Group Health, Individual Health and Medicare clients of ABM Insurance & Benefit Services will continue to receive updates regarding changes in the program and benefits as they relate to your plans.    If you have questions, contact our office at 800-362-2809 or visit us at www.cobensrv.com    Hope you and your family remain safe!