Maryland Insurance Commissioner Kathleen A. Birrane reminds all Marylanders that they cannot be billed for COVID-19 vaccinations regardless of which vaccine they receive.
While the Maryland Insurance Administration has not seen evidence of attempts by providers to bill individuals for vaccine administration in Maryland, we are aware that in other states individuals have been charged for the administration of the more recently approved Johnson & Johnson vaccine.
As set forth in the Commissioner’s December 15th Consumer Advisory, health insurance issuers must cover the administration of vaccines authorized by the FDA for the prevention of coronavirus disease 2019 without charge regardless of which vaccine you receive. The cost protections ordered by the Hogan Administration are broader than those afforded under the federal CARES Act, because they apply to all health plans that include vaccination coverage that are issued by health insurers in Maryland, not only the non-grandfathered ACA plans referenced under federal law.
Doses of the vaccine that are purchased with U.S. taxpayer dollars will be provided at no cost. Vaccination providers are eligible to be reimbursed from an insurer or from the federal government when they administer the vaccine, but may not charge individuals.
As the Center for Disease Control and Prevention has stated:
All organizations and providers participating in the CDC COVID-19 Vaccination Program:
- must administer COVID-19 vaccine at no out-of-pocket cost to the recipient;
- may not deny anyone vaccination based on the vaccine recipient’s coverage status or network status;
- may not charge an office visit or other fee if COVID-19 vaccination is the sole medical service provided;
- may not require additional medical services to receive COVID-19 vaccination;
- may seek appropriate reimbursement from a program or plan that covers COVID-19 Vaccine administration fees for the vaccine recipient, such as:
– vaccine recipient’s private insurance company
– Medicare or Medicaid reimbursement
– HRSA COVID-19 Uninsured Program for non-insured vaccine recipients
- may not seek any reimbursement, including through balance billing, from the vaccine recipient.