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C-U Public Health hopes to ensure access to the COVID booster, regardless of insurance coverage

Melissa White, a medical assistant with Prism Health Lab, draws up a dose of the Pfizer-BioNTech vaccine at a COVID-19 pop-up clinic in Cobden, Ill., on Feb. 27, 2021.

The new COVID-19 booster shot has rolled out at local pharmacies. The shots were approved earlier this month by the Food and Drug Administration and are recommended by the Centers for Disease Control and Prevention for everyone six months and older.

All prior COVID-19 shots have been paid for by the federal government. But the end of the federal COVID-19 emergency order in May caused all further COVID-19 vaccines to be commercialized. This means the cost of the vaccine is now up to insurance providers or individuals themselves to cover. 

People covered by Medicare, Medicaid and private health insurance plans can still get free shots because federal law requires coverage with no cost-sharing for all vaccines recommended by the CDC’s Advisory Committee on Immunization Practices.

But those without insurance will be asked to foot the bill for the shots.

“That’s a concern because pharmacies and all of those private entities now are going to be charging for it,” said Brandon Meline, director of Maternal and Child Health at the Champaign-Urbana Public Health District. “It’s not a cheap vaccine if you have to pay retail for it.” 

He said the health district wants to ensure that everyone will be able to receive the vaccine, whether that’s through working with their partners like schools and employers or reaching out to those who are uninsured. 

“We’re trying to look at our response for offering the vaccine through the equity lens, trying to make sure that those at risk or those that might be disadvantaged when it comes to being able to pay for it out of pocket – those are the folks that we really want to make aware that they’ll be able to get that through public health,” Meline said. 

Meline also worries about administrative hurdles that may prevent the vaccine from being covered by insurance plans right away.

“Just because it’s commercialized doesn’t mean that each insurance plan has actually gone through their administrative process to get it into their insurance plans and covered,” Meline said. 

“There might be issues, you know, with people going to a pharmacy and [thinking] that they have that benefit covered, and then lo and behold, they’re going to get an invoice for it.” 

Before getting the booster, Meline recommends people with insurance call their insurance providers to make sure the vaccine is covered in their plan. 

Uninsured people can get free vaccines through the CDC’s Bridge Access Program, which will provide vaccines free of charge through the end of 2024. Uninsured children are able to receive the new booster and other vaccinations for free under the Vaccines for Children Program. The CDC also has a site for finding no-cost shots.

Director of McKinley Health Center Awais Vaid said he’s also concerned about people not receiving the new vaccine but for a different reason: They simply don’t want to. 

Vaid said around 90% of the University of Illinois at Urbana-Champaign campus received the primary series of the vaccine. But when the previous booster was available, he estimated only 20% to 30% of individuals got the booster.

He said this was a trend not just seen on campus but around the country. 

Vaid strongly encourages everyone to still get the updated booster shot to stay protected from the circulating strain of the virus. 

“Why would you want to take a chance when you know there’s an effective vaccine out there?” Vaid said.

“We know that the vaccine does not prevent COVID-19. But it prevents individuals from getting really sick or having complications or hospitalizations.”

Vaid said he’s hopeful because he has already seen a significant demand for the booster in the community since pharmacies are filling up appointments. 

Booster shots are currently available at local pharmacies. Meline said the CUPHD should receive a supply of the vaccine within the next couple of weeks and to check the health district’s COVID-19 site for updates.

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