![]() The Biden administration shifted funding to purchase additional kits and made them available in late December.For more information about the Coronavirus (COVID-19), including vaccine information, visit our FAQs page. Rules remain in place for insurers, including Medicare and Affordable Care Act plans, to cover the cost of up to eight in-home test kits a month for each person on the plan, until the public health emergency ends.įor consumers - including those without insurance - a government website is still offering up to four test kits per household, until they run out. At-home COVID tests won't be free for many people "They may not realize they've lost coverage until they go to fill a prescription" or seek other medical care, including vaccinations, he said. Care, the nation's largest publicly operated health plan with 2.7 million members. 1 concern" right now, said John Baackes, CEO of L.A. In April, states will begin reassessing whether Medicaid enrollees meet income and other qualifying factors.Īn estimated 5 million to 14 million people nationwide might lose coverage. ![]() Meanwhile, the treatment will also need to go through the regular FDA approval process, which takes longer than the emergency use authorization under which it has been marketedĪnother complication: The rolls of the uninsured are likely to climb in the next year, with states poised to reinstate the process of regularly determining Medicaid eligibility that sort of review was halted during the pandemic. Medicare beneficiaries will face cost-sharing for most COVID-19 treatments once the emergency officially ends and the government supply runs out. Medicaid will continue to cover it without cost to patients until at least 2024. Meanwhile, public policy experts say many private insurers will continue to cover Paxlovid, although patients may face a copayment, at least until they meet their deductible, just as they do for other medications. ![]() Those increases, he said, will also affect people with insurance, as the costs "flow through to premiums." COVID-19 treatments will cost more, too. If they cannot find a free or low-cost option, some uninsured patients may feel forced to skip vaccinations or testing.Ĭoming up with what could be $100 or more for vaccination will be especially hard "if you are uninsured or underinsured that's where these price hikes could drive additional disparities," said Sean Robbins, executive vice president of external affairs for the Blue Cross Blue Shield Association. And people who don't have insurance will need to either pay full cost out-of-pocket or seek no- or low-cost vaccinations from community clinics or other providers. People with limited-benefit or short-term insurance policies might have to pay for all or part of their vaccinations. Many people with job-based insurance will also likely not face copayments for vaccines, unless they go out-of-network for their vaccinations. Medicare beneficiaries, those enrolled in Medicaid - the state-federal health insurance program for people with low incomes - and people who have health plans via the Affordable Care Act exchanges will continue to get COVID-19 vaccines without charge, even when the public health emergency ends and the government-purchased vaccines run out. One thing is certain: How much, if any, of the boosted costs are passed on to consumers will depend on their health coverage. The type of health insurance you have will determine how much more you'll pay The government's bulk purchase price from manufacturer Pfizer was $530 for a course of treatment, and it isn't yet known what the companies will charge once government supplies run out. to get a bivalent booster at the average price paid by the federal government.Īs for COVID treatments, an August blog post by the Department of Health and Human Services' Administration for Strategic Preparedness and Response noted that government-purchased supplies of the drug Paxlovid are expected to last at least through midyear before the private sector takes over. That's up to nearly twice as much as what it would have cost for every adult in the U.S. If half of adults - about the same percentage as those who opt for an annual flu shot - get a COVID shot at the new, higher prices, a recent KFF report estimated, insurers, employers and other payors would shell out $12.4 billion to $14.8 billion. And consumers would foot the bill, either directly (in copays) or indirectly (through higher premiums and taxpayer-funded subsidies). That could translate to tens of billions of dollars in revenue for the manufacturers, even if uptake of the vaccines is slow. The company expects a gross price - the full price before any discounts - of $110 a dose, which, Richardson said, "is more than justified from a health economics perspective." "We see a double-digit billion market opportunity," investors were told at a JPMorgan conference in San Francisco recently by Ryan Richardson, chief strategy officer for BioNTech. ![]()
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