How Much Is The Covid Vaccine Without Insurance- Costs, Insurance, Billing, And More Explained

As the virus continues to spread time and again due to new strains such as the delta variant, pharmacies must continue to provide vaccines to eligible individuals.

What is the 2019 coronavirus?

In late 2019, a new virus made news worldwide due to the remarkable pace with which it spread. In December of this year, its roots may be traced back to a food market in Wuhan, China. It’s spread to countries as far apart as the United States and the Philippines.

The virus (SARS-CoV-2) has infected over 200 million people worldwide and killed over 4.5 million people. The United States is the country with the most deaths. The condition produced by SARS-CoV-2 is known as COVID-19, which stands for coronavirus disease 2019.

How does the coronavirus spread?

According to researchers, the coronavirus is disseminated through droplets and virus particles released into the air when an infected person breathes, talks, laughs, sings, coughs, or sneezes. Larger droplets may fall to the ground in a matter of seconds. Still, microscopic infectious particles can persist in the air and concentrate in enclosed spaces, mainly where many people are assembled, and ventilation is poor. COVID-19 prevention necessitates masks, hand cleanliness, and physical separation.

How did the coronavirus start?

The first case of COVID-19 was reported on December 1, 2019, and the cause was a new coronavirus called SARS-CoV-2. SARS-CoV-2 may have started in an animal and evolved (mutated) into a virus that can infect humans. Viruses that originated in birds, pigs, bats, and other animals changed to become hazardous to people in the past, causing multiple infectious disease outbreaks. More research is needed to understand how and why the coronavirus evolved to produce pandemic sickness.

How are coronavirus infections diagnosed?

COVID-19 has been diagnosed the same way other viral infections are: with a blood, saliva, or tissue sample. Most tests, however, take a sample from the inside of your nostrils with a cotton swab.

Locations that conduct tests include:

• the CDC
• some state health departments
• commercial companies
• certain pharmacies
• clinics and hospitals
• emergency rooms
• community testing centers

Visit the websites of your state’s health department or the U.S. Department of Health & Human Services to find out where testing is offered near you.

At-home tests

The Food and Drug Administration (FDA) approved the first emergency use authorization (EUA) for a COVID-19 self-testing kit on November 17, 2020. The EUA states that the test kit is approved for use by people aged 14 and up who have been diagnosed with COVID-19 by a healthcare practitioner.

The Lucira COVID-19 All-In-One Test Kit is a quick test that eliminates the need to send a nose swab sample to a lab. The test kit is only accessible with a prescription and claims to provide findings in 30 minutes.

The FDA approved using the first COVID-19 home collection kit on April 21, 2020. Pixel by LabCorp is the company behind it. You’ll be given a cotton swab to capture a nasal sample and mail it to a designated laboratory for testing. It’s authorized for use in people ages 18 years and older.

Additional at-home kits, such as those from EverlyWell and QuickVue, received EUAs from the FDA in mid-2021.

Emergency use authorizations (EUAs) allow the use of medical items that have not yet received FDA approval (FDA). The FDA issues EUAs when there are no FDA-approved alternatives for diagnosing, treating, or preventing a severe illness.

When to see your doctor?

Talk with your doctor if you think you have COVID-19 or notice symptoms.

Your doctor will advise you on whether you should:

• stay home and monitor your symptoms
• set up a telehealth visit
• come into the doctor’s office to be evaluated
• go to the hospital for more urgent care

Who’s at increased risk?

If you contact someone who has SARS-CoV-2, you’re at a high risk of contracting it, especially if you’ve been exposed to their saliva or been near them when they coughed, sneezed, or talked.

Without taking proper preventive measures, you’re also at high risk if you:

• live with someone who has contracted the virus
• are providing home care for someone who has contracted the virus
• have an intimate partner who has contracted the virus
• Older adults and people with certain health conditions have a higher risk of severe complications if they contract the virus. These health conditions include:
• cancer
• extreme heart conditions, such as heart failure, coronary artery disease (CAD), and cardiomyopathy
• chronic kidney disease
• chronic obstructive pulmonary disease (COPD)
• obesity, a condition that develops in people with a body mass index (BMI) of 30 or higher
• sickle cell anemia
• a weakened immune system from a solid organ transplant
• type 2 diabetes

COVID-19 vaccine cost at pharmacies

The U.S. placed an initial order for 100 million doses of Pfizer and Moderna vaccines as part of Operation Warp Speed. The Pfizer vaccination costs $19.50 for each dosage, while the Moderna vaccine costs $32.

When taking the vaccine during the pandemic, federal officials have stated that you should not be charged (regardless of whether or not you have health insurance). You may still be charged for vaccine administration, but you will almost certainly not be charged for administration at pharmacies.

However, the cost of the COVID vaccine without insurance may vary depending on where and when you get vaccinated. We anticipate that uninsured people will pay between $24.38 and $57.60 once the pandemic is gone.

Pharmacies administering the COVID-19 vaccine

The Federal Retail Pharmacy Program for COVID-19 Immunization is a partnership between the federal government, states, territories, and 21 national pharmacy partners and independent pharmacy networks to expand COVID-19 vaccination availability across the country. This program will make the COVID-19 vaccine available at CVS, Walgreens, Walmart, Rite Aid, Kroger, Publix, and other locations.

Below is a complete list of the pharmacies that will be administering the COVID-19 vaccine:

CVS (including Long’s)

Previously, CVS administered the COVID-19 vaccine to high-priority groups before administering the vaccine to a broader group. However, the vaccine can now be given to all individuals aged 12 and above at these stores. The target vaccination clinics can be found in:

• California
• Connecticut
• Hawaii
• Maryland
• Massachusetts
• New Jersey
• New York
• Rhode Island
• South Carolina
• Texas
• Virginia

Walgreens (including Duane Reade)

Since December 21, 2020, Walgreens has distributed over 147.6 million COVID-19 immunizations to long-term care facilities. Walgreens also has vaccines accessible for sale to the general public in its 9,000 locations.

Is the COVID-19 vaccine free if you’re uninsured?

In the United States, most health insurance companies cover COVID-19 immunizations at no cost to members. However, due to the economic impact of the COVID-19 pandemic, approximately 30 million Americans were uninsured in 2019, and that number is anticipated to rise in 2020.

Is it possible to receive a COVID-19 vaccine for free if you don’t have health insurance to cover the cost? Probably, but you’ll want to keep an eye on things to make sure you don’t get a bill for a vaccine you thought was free.

How much do vaccines cost without insurance?

The vaccine is still available for free! Your vaccine is still covered whether you don’t have insurance or if your insurer requires you to pay a portion of the cost. The COVID-19 Uninsured Program can reimburse healthcare professionals who vaccinate you. For underinsured people, there is also the COVID-19 Coverage Assistance Fund. The payments are sums of money granted by the government to help healthcare personnel and hospitals on the front lines of the pandemic.

Uninsured children

Uninsured children will get a COVID-19 vaccine free of charge from doctors who participate in the Vaccines for Children (VFC) program once approved for use in children by the Centers for Disease Control and Prevention (CDC).

The VFC program is a government program that offers vaccine money to Medicaid-eligible, uninsured, underinsured, American Indian, or Alaskan native people under the age of 19.

The VFC program is specifically designed to ensure that children receive immunizations regardless of their family’s financial situation. Most doctors in the United States provide the VFC program.

Uninsured adults

No safety-net program ensures uninsured adults access to immunizations, even though adults are more likely than children to be uninsured. On the other hand, the government has set aside money to reimburse medical providers who give COVID-19 vaccines to uninsured persons.

The Provider Relief Fund was established by the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act (PP HCEA), both enacted in the spring of 2020.

The Health Resources and Services Administration (HRSA) manages the fund, intended to give financial support to medical providers who engage in Medicare and Medicaid.

A significant chunk of the fund will be used to reimburse medical practitioners for the expense of immunizing uninsured people. While the federal government is responsible for delivering the vaccine free of charge to states, the Provider Relief Fund is intended to reimburse providers for the costs associated with giving the vaccination.

Nonetheless, when COVID-19 immunizations are spread through 2021, the money will most likely be drained. If this happens, Congress will need to approve additional funding to ensure that these costs are covered, and that uninsured people can receive vaccinations.

The term “uninsured” can apply to people who have types of coverage that don’t technically count as health insurance, such as a fixed indemnity plan or healthcare sharing ministry plan. If your health plan doesn’t cover the cost of the COVID-19 vaccine, it may be because the plan isn’t technically health insurance.

How to get low-cost vaccines for uninsured adults?

Medical professionals have been able to request reimbursement for the cost of COVID-19 testing and treatment for uninsured persons through the Provider Relief Fund from the beginning of the pandemic. However, they are not compelled to do so, and some have instead chosen to bill the patient directly.7

Even if the vaccine is free, there are fears that the cost of COVID-19 vaccination could rise in the same way. Uninsured Americans may be hesitant to seek vaccination if there is a danger they would be charged.

As a result, it is on to you, the customer, to inquire about any payments associated with vaccine administration. If there are, you may want to find a provider near you who participates in the Provider Relief Fund.

Contacting your local health department or using the internet locator provided by the United States Department of Health and Human Services (HHS), which searches providers based on your zip code, is one way to do so.

Finally, if a provider receives reimbursement from the Provider Relief Fund for COVID-19-related services, the provider is not permitted to bill the patient and must accept the reimbursement as full payment.

Is there any way I could get a bill?

If you obtain a COVID-19 vaccine as part of a doctor’s office visit that you go to for many reasons, you might get a bill — but the bill will be for seeing the doctor, not for the vaccine.

If you want to talk about your cholesterol or shoulder discomfort while getting a vaccine, your visit will require more than simply vaccination. Then you’ll most likely have to pay for the appointment, such as a usual copay or coinsurance if you have insurance, but not for the COVID-19 vaccine or the administration price.

If you receive a bill for the COVID-19 vaccine in error, contact your health insurer or, if you’re uninsured, your healthcare provider and explain the situation. Under the CARES Act, most COVID-19 testing was also meant to be free. However, some people received invoices that needed to be addressed.

What to do if you are billed?

If you receive a balance-due charge for vaccination after the Provider Relief Fund has paid a portion of the amount, you should contact the provider. There should be no costs unless you acquired additional services unrelated to COVID-19. 8

On the other hand, the patient may be responsible for the entire amount if the provider does not receive compensation through the Provider Relief Fund. So, once again, it’s critical to inquire upfront about potential vaccination-related modifications and whether the provider uses the Provider Relief Fund.

If you suspect you are being overcharged, file a consumer complaint with your state’s Department of Health.

Who is not eligible for the COVID-19 vaccine?

A COVID-19 vaccination that has been licensed by the FDA is not currently available to children under the age of five. Instead, their parents have had to assist them in using alternative public-health measures to avoid contracting and spreading the illness, such as face masks and social separation.

The FDA approved Pfizer’s low-dose COVID-19 vaccination for children aged 5 to 11 in November 2021. It was the first pediatric vaccine to receive FDA approval in the United States.

Where can I get the vaccine?

Vaccine supplies were highly restricted in late 2020 and early 2021. Officials from the government rationed the shots based on priority groups’ eligibility. Vaccines are now widely available and available to anyone aged five and up at a variety of sites, including:

• Pharmacies
• Supermarket chains
• Healthcare facilities such as clinics
• Community health centers (many participate)
• County health departments

You can visit Vaccines.gov to find a COVID-19 vaccine or booster shot near you and make an appointment.

Items to bring to your COVID-19 vaccine appointment

To receive your COVID-19 immunization, you must bring the following items to your visit. Please remember that you will only receive your vaccine if you are eligible and have an appointment during the current distribution phase in your state.

• Government-issued picture I.D.
• Insurance Card (if you are uninsured, you can still receive a vaccine, free of charge)
• Mask/Face Coverings to be Worn at All Times (even if you’re waiting in line outside)
• Copy of your Appointment Confirmation (you may want to print it out)
• For your second vaccine appointment, it is advised that you bring your vaccination card

Is it free for everyone?

The federal government is paying for the vaccine. It had spent $10 billion on COVID-19 vaccine research, production, and distribution by 2020. The Biden administration added roughly $10 billion to the American Rescue Plan in 2021 to expand vaccination access. The Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was signed into law in March 2020, and a patchwork of other laws, make the vaccines accessible to the public.

Early in the epidemic, Centers for Medicare & Medicaid Administrator Seema Verma told NPR that if you’re protected by Medicare or Medicaid, your vaccine is paid for by Medicare’s trust fund. The Centers for Medicare and Medicaid Services (CMS) intended to spend about $3 billion to vaccinate about 130 million Medicare and Medicaid recipients. For Medicare beneficiaries, the vaccine is covered under Part B.

“Medicare beneficiaries will continue to receive coverage of the COVID-19 vaccine without cost-sharing, similar to other preventive vaccines covered under Medicare Part B,’ a CMS spokesperson wrote to GoodRx Health.

When acquiring a COVID-19 vaccine, you won’t have to worry about balance billing or surprise billing if you have commercial insurance and go to an out-of-network provider. It would help if you didn’t have any out-of-pocket expenses, regardless of where you obtain them. That means you won’t have to waste time figuring out if a drugstore or doctor’s office is in your insurer’s network before you go.

What will the vaccine cost after the pandemic?

Though it’s uncertain how much the COVID-19 vaccine will cost once the epidemic is finished, it’ll most likely be handled the same way as other vital immunizations like the flu shot and the measles, mumps, and rubella (MMR) vaccine.

“For health insurance plans that are subjected to the coverage of preventive services without cost-sharing requirement, the CARES Act ensures that the COVID-19 vaccine will be added to the list of required preventive care coverage without the 1-year delay,” Nguyen said.

People on private health insurance plans or Medicare Part B will most likely be able to get the vaccine for free.

“After the federal public health emergency period ends, insurers will cover the COVID-19 vaccine according to essential health benefit coverage rules,” the Oscar Health spokesperson said.

The future vaccine costs for uninsured people are less concrete, but Nguyen suspects it may be pricier than other routine vaccinations.

“For the uninsured, I expect the cost to be higher than that of a flu vaccine due to the cold storage requirement of the vaccine,” Nguyen said. “Furthermore, there is no regulation on how much providers can charge uninsured patients once the pandemic status is lifted.”

Will the vaccine always be free?

Officials announced that as part of the public health emergency, the COVID-19 vaccines would be accessible in 2020 and 2021. As the COVID-19 vaccines from Pfizer/BioNTech and Moderna became fully licensed vaccinations used in routine preventive treatment, they may be subject to the same payment rules as other vaccines like the flu vaccine.

Routine immunizations must be covered as preventative care in all health plans that comply with the Affordable Care Act (ACA) of 2010, with no out-of-pocket payment to the patient. On the other hand, short-term health plans are exempt from ACA requirements. According to the Kaiser Family Foundation, such programs may require you to pay a portion of the cost of the COVID-19 vaccine or may not cover it at all. However, many private insurers, such as Anthem and United Healthcare, have indicated that COVID-19 vaccines will be covered without deductibles, copayments, or coinsurance in all of their health plans during the public health emergency.

Other treatments

Scientists are also looking at other ways to target the virus or treat the complications of COVID-19.

• Antibody cocktail. In July 2020, researchers at Columbia University in New York announced some initial success in using a mix of antibodies to potentially treat people with a SARS-CoV-2 infection. They said the antibodies were collected from people hospitalized with COVID-19. The drug mixtures were tested on human cells as well as hamsters.

If proven safe and effective, the antibodies would be given to people who recently contracted the virus via blood transfusions.

• Antiviral drugs. In September 2021, Pfizer and Merck announced new clinical trials for their oral antiviral medications to treat COVID-19. The Pfizer drug, known as PF-07321332, is designed for people with COVID-19 who are not considered high risk for serious illness.

The Merck pill, which goes by the name molnupiravir, is designed for people living in the same household as someone with an asymptomatic case of COVID-19. Both medications are designed to prevent the novel coronavirus that causes COVID-19 from replicating.

• In late July 2020, Yale University announced it’s conducting a trial with A.I. Therapeutics on a drug known as apilimod. Yale officials said the medication had been proven safe in treating autoimmune diseases and follicular lymphoma.

They said preliminary research indicates apilimod can block cellular entry of the new coronavirus. The drug has been granted fast-track status by the FDA.

• Arthritis drugs. In early January 2021, hospital officials in the United Kingdom reported that tocilizumab and sarilumab, drugs used to treat arthritis, can reduce the length of time spent in a hospital by ten days. They added that the two drugs could reduce the risk of death from COVID-19 by 24 percent for people who are seriously ill with the disease.
• Blood thinners. In mid-September 2020, U.S. researchers announced they’d started two clinical trials to examine the possibility of using blood thinners to treat COVID-19. One trial would focus on people with COVID-19 who have been hospitalized, while the other would center on those with COVID-19 who weren’t hospitalized.

In mid-February 2021, a study reported that blood thinners given as a preventative treatment to people within 24 hours of their hospitalization for COVID-19 reduced the risk of death from the disease.

• Cannabinoid drug ARDS-003. In mid-September, officials at Canada-based Tetra Bio-Pharma announced they had received FDA approval to start a phase 1 trial of a synthetic cannabinoid drug to treat COVID-19.

Company officials said the medication might protect against ARDS, a condition that’s the most common cause of death for people with severe COVID-19.

• Diabetes drug. In late September 2020, researchers reported that the diabetes drug sitagliptin reduced death and improved clinical outcomes in people with type 2 diabetes who were given the drug after being hospitalized for COVID-19.

Researchers said it’s possible that sitagliptin could also help people without type 2 diabetes who develop COVID-19.

• Feline coronavirus drug. In early September 2020, a study reported that a drug sometimes used to treat a coronavirus illness in cats showed promise in a trial against COVID-19 in humans.

The FDA hasn’t approved the drug for use in cats or people, but researchers say it’s shown indications it can stop SARS-CoV-2 from replicating by targeting a vital part of the virus’s cellular machinery.

• Gout drug. A study published in early February 2021 reported that colchicine, a drug used to treat gout, reduces the need for supplemental oxygen and speeds up the recovery of people hospitalized with COVID-19. Researchers said people treated with colchicine needed oxygen to help them breathe for three fewer days on average. They also spent, on average, two fewer days in the hospital.
• In early June 2020, scientists started a clinical trial to see whether the pain medication could be used for people hospitalized with COVID-19.

Their theory is that ibuprofen’s anti-inflammatory qualities could help ease breathing difficulties associated with the illness.

• Interferon-beta. In mid-July 2020, scientists in the United Kingdom reported success in initial tests with an interferon beta protein. The body produces this protein during viral infections.

The researchers said the protein is inhaled directly into the lungs of someone with a SARS-CoV-2 infection in hopes of stimulating an immune response. They said the protein reduced the odds of developing a severe form of the disease in hospitalized patients by 79 percent. Preliminary results from a study by the World Health Organization found that interferon-beta didn’t help people with COVID-19.

• This drug, manufactured by Merck, is an oral antiviral agent. In early March 2021, a phase 2a clinical trial indicated the drug might reduce the length of illness derived from COVID-19 infections.
• Nasal spray. In late September 2020, officials at Australian biotech company Ena Respiratory reported that a nasal spray used to treat colds and flu was highly influential in an animal study in reducing SARS-CoV-2 replication. Human trials are scheduled to start soon.
• Nitric oxide. In October 2020, Nitric Oxide Innovations (NOI) LLC announced plans to begin a phase 2B and 3A outpatient clinical study of NOviricid, an oral lozenge that stimulates the production of nitric oxide in the body. The study will enroll African Americans, a group that has been disproportionately affected by COVID-19.

Earlier research has suggested that nitric oxide might work as a treatment for COVID-19 by improving blood vessel function. It may also prevent certain viruses from replicating.

• Synthetic antibodies. In mid-August 2020, scientists at the University of California, San Francisco, announced they had created synthetic antibodies that may neutralize the new coronavirus.

The compound still has to go through clinical trials, but the scientists said it could be available within a few months in a nasal spray or inhaler.

• Repurposed drugs. A study released in September 2021 reported nine currently used drugs that could be repurposed to treat COVID-19. In a trial on human cells, the researchers said these drugs help stop the novel coronavirus from replicating after it has entered a cell. The drugs have not been tested yet on patients.
• Hydroxychloroquine and chloroquine. These drugs received emergency use authorization from the FDA in March 2020. On June 15, the FDA revoked that authorization, citing studies that indicated hydroxychloroquine didn’t significantly help people with COVID-19 and may have caused severe health risks.

The bottom line

COVID-19 vaccines are widely available and accessible for everyone aged five and older in the U.S., regardless of insurance or immigration status, during a public health emergency. You can get a vaccine at a pharmacy, community health center, or healthcare provider’s office.

If you get a shot at a provider’s office, you could get a bill if you receive other services besides the vaccine. Otherwise, you should not be billed for any part of a COVID-vaccine visit, whether for the shot itself or an administration fee. If you do get a bill, don’t pay it while working out the error with the insurance company or provider.