Medicare May Not Cover the Coronavirus Vaccine After All

While Medicare would cover a coronavirus vaccine approved through normal channels, if the Food and Drug Administration approves the vaccine through an emergency use authorization (EUA), Medicare will not cover it unless the government acts.

Posted on September 28, 2020

As we previously reported, the CARES Act provides that if a COVID-19 vaccine becomes available, Medicare is required to cover this vaccine under Part B with no cost sharing. Medicare Advantage plans are required to include the basic coverage offered by Medicare Parts A and B, so this coverage also applies to beneficiaries in Medicare Advantage plans.

However, it is possible that the federal government will authorize the use of the vaccine through an EUA, which is a faster method of approving drugs needed in a crisis situation, like the coronavirus pandemic. Medicare does not cover costs of vaccines approved under EUAs.

In order to ensure that the vaccine is free, the government will need to act. One option is that Congress could change the language in the CARES Act to ensure coverage. In addition, doses purchased by the federal government will be free of charge.