Guests from Omnicare/CVS on LeadingAge’s member call addressed a number of issues related to COVID, flu, and RSV vaccines. In particular, they offered a quick primer on coverage. More details will be addressed related to recommendations, approvals, effectiveness, and the underlying science of these vaccines and boosters on Wednesday’s call interview with CDC officials.
For now: COVID vaccines, including the new monovalent vaccine (the bivalent is no longer authorized for use in the U.S.) follow different coverage policies now that the Public Health Emergency is ended. For Medicare beneficiaries not in a Part A covered stay, the COVID vaccine, like the flu vaccine, is covered without cost sharing under Part B. Medicaid programs must cover the COVID vaccine without cost sharing. For individuals in a Part A SNF stay, both the COVID and flu vaccines fall under consolidated billing. The RSV vaccine is covered without cost sharing under Part D when provided in-network by the individual’s plan. Not all plans have announced they will cover it yet, but it is expected that they will.
