:max_bytes(150000):strip_icc()/GettyImages-1344723070-6f62d1c477ff4e31b8dbdf1205e463ca.jpg)
COVID Vaccine Coverage May Shift This Week as CDC Considers Age Advice
Consumers seeking a COVID-19 vaccine covered by insurance should act quickly, as a key CDC advisory group is poised too perhaps alter vaccine recommendations that could impact cost-sharing for millions. The Advisory Committee on Immunization Practices (ACIP) is reportedly considering raising the recommended age for routine vaccination from 65 to 75, a change that could mean insurers are no longer required to cover the vaccine at no cost for those aged 65-74.
Currently, most insurance plans fully cover COVID-19 vaccines due to federal guidelines. Though, if the ACIP raises the recommended age, insurance coverage for those outside the new recommendation could shift, potentially requiring copays or other out-of-pocket expenses. While the CDC’s decision isn’t final, the potential change has prompted a pledge from health insurance trade group AHIP, representing companies like Aetna, Cigna, and Blue Cross Blue Shield branches in some states, to continue providing coverage through 2026 irrespective of the ACIP’s decision.
as of September 18, 2024, the 2025-2026 vaccine is available at CVS Health and Walgreens in most states without a prescription. However, over a dozen states require a prescription for the vaccine at one or both pharmacies. In Florida, CVS requires a prescription while Walgreens currently does not offer the vaccine, stating availability will follow ACIP eligibility guidance.
“While health plans continue to operate in an environment shaped by federal and state laws, as well as program and customer requirements, the evidence-based approach to coverage of immunizations will remain consistent,” AHIP stated.
