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Coverage
is Available for COVID-19 Vaccinations for Eligible Children Ages 5 through
11 Coverage
without cost-sharing is available in Medicare, Medicaid, CHIP, and the
commercial health insurance market Following the U.S. Food & Drug
Administration’s (FDA) recent action authorizing the Pfizer-BioNTech COVID-19
Vaccine for the prevention of COVID-19 in children 5 through 11 years of age
and a recommendation from the Centers for Disease Control and Prevention
(CDC), the Centers for Medicare & Medicaid Services (CMS) is reminding
eligible consumers that coverage is available without cost-sharing under
Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and in
the commercial market for this critical protection from the virus without
cost sharing. As with all vaccines, the Pfizer-BioNTech COVID-19 Vaccine was
tested thoroughly in this age group prior to its authorization for emergency
use. While the effects of COVID-19 for a child can last for several months,
the most commonly reported side effects of the COVID-19 vaccine in the
clinical trial participants were generally mild to moderate in severity, and
most went away within one to two days. “The COVID-19 vaccine is the best way to keep
children safe. The strongest protection against COVID-19, including the Delta
variant, is to get vaccinated,” said CMS Administrator Chiquita Brooks-LaSure.
“I encourage parents everywhere to talk with their pediatrician, school
nurse, or other trusted healthcare provider about any questions they may have
and to get their children vaccinated as soon as possible.” Thanks to the American Rescue Plan Act of
2021 (ARP), nearly all Medicaid and CHIP beneficiaries are eligible to
receive coverage of COVID-19 vaccines and their administration without
cost-sharing. Beneficiaries with Medicare pay nothing for COVID-19 vaccines
or their administration, and there is no applicable copayment, coinsurance,
or deductible. COVID-19 vaccines and their administration will also be
covered without cost-sharing for eligible consumers of most issuers of health
insurance in the commercial market. People can visit vaccines.gov
(English) or vacunas.gov
(Spanish) to search for nearby locations to receive a vaccine. Additionally, under the terms of the CDC
COVID-19 Vaccination Program Provider Agreement, health care providers and
other entities administering COVID-19 vaccines must agree not to deny anyone
a COVID-19 vaccination based on their health coverage status, and must also
agree to administer COVID-19 vaccines at no out-of-pocket cost to recipients.
More information regarding the CDC COVID-19 Vaccination Program Provider
Requirements and how the COVID-19 vaccine is provided through that program at
no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html
and through the CMS
COVID-19 Provider Toolkit. ### Get CMS
news at cms.gov/newsroom,
sign up for CMS news via
email and follow CMS on @CMSgov |
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To be a Medicare Agent's source of information on topics affecting the agent and their business, and most importantly, their clientele, is the intention of this site. Sourced from various means rooted in the health insurance industry - insurance carriers, governmental agencies, and industry news agencies, this is aimed as a resource of varying viewpoints to spark critical thought and discussion. We welcome your contributions.
Wednesday, November 3, 2021
Coverage is Available for COVID-19 Vaccinations for Eligible Children Ages 5 through 11
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