It’s been just over a week since the U. S. Food and Drug Administration had taken a ruling. The U. S. Centers for Disease Control and Prevention and the U. S. Centers for Disease Control and Prevention have not allowed the U. S. Department of Disease Control and Prevention to do so. The U. S. government gave the green light to updated Covid-19 vaccines, urging Americans to get their hands on them without delay as the country sees it. a slight increase in cases, hospitalizations and deaths.
“These vaccines are already available. They’re in pharmacies, doctors’ offices and gyms across the country,” Dr. Nirav Shah, principal deputy director of the CDC, told CNN on Saturday.
The company recommends that anyone 6 months or older receive one of the new injections. He made the same recommendations for flu vaccines, which are also available now and can be given at the same time as the new Covid-19 vaccines.
At least in theory.
Some other people have already scheduled appointments and been vaccinated, but others who tried to comply with CDC rules faced barriers that didn’t exist before the government announced Covid-19 vaccines this year. Some pharmacies have scheduled appointments for vaccines only to cancel them. when they run out of doses. And other people came to their vaccination appointments expecting insurance to fully cover the charge, only to be told they had to pay out of pocket for the vaccine, which costs between $100 and $200, with an administrative fee.
CDC referred questions about the problems to the Center for Medicare
On Wednesday, at a press conference where he won his own Covid and flu shots, Xavier Becerra, secretary of the Department of Health and Human Services, said they were running to mitigate any problems.
“We hear those stories and communicate with insecure people. We’re reaching out to pharmacists and we’re enforcing it, and to make sure everyone understands how it works, you shouldn’t have to pay out of pocket if you’re not sure. “Becerra said, adding that vaccines are also available for others who have questions through the Bridge Access Program.
For the most part, the disruptions appear to be short-term disruptions, such as limited initial materials or difficulties setting up the right codes for billing insurance, but experts say they were also preventable disruptions that are slowing the momentum of the fall vaccination campaign at a rapid pace. Critical moment. Last year, most people who received a bivalent Covid-19 vaccine did so within the first two months of approval, according to CDC data.
“This is all temporary,” said Jen Kates, senior vice president of the Kaiser Family Foundation, which tracks access to vaccines. “This is the first time they have been commercialized. There are things to implement, so it’s temporary. “It must also be said that insurers knew this was going to happen for a long time. “
CVS said it has had to reschedule some appointments because it receives vaccines on an ongoing basis. Walgreens described any problems as isolated and said it now has enough materials to meet existing vaccination appointments at as many stores as possible. It plans to offer more appointments later this week. .
Rite Aid and Walmart said they had not started scheduling appointments for vaccines but expected to get their first deliveries of updated Covid-19 vaccines this week.
In past Covid-19 vaccination campaigns, when the government was in charge of buying, distributing and tracking vaccines, Kates says Americans were given a glimpse of what universal physical care could look like and everyone had access to it.
“Now, what has happened with marketing is that we are returning to health care as we know it, with its demanding and complex situations,” he said.
Kira Kiessling, 38, of Washington, D. C. , recently scheduled an appointment to receive flu and COVID-19 shots in anticipation of an upcoming business trip. She wanted to be protected.
“The CDC says it’s time. Everyone will have to get vaccinated. In theory, this week we will receive flu shots and next week, Covid vaccines,” he said.
But when he went to the supermarket pharmacy where he got all his previous vaccines without a problem, he said he would have to pay out of pocket if he wanted to get vaccinated. Kiessling and his circle of family are covered through CareFirst Blue Cross. and Blue Shield through her husband’s employer.
She should check it out by talking to her insurance company.
When she called CareFirst, she said, she was told there was a network-wide challenge with billing for all vaccines. Customer service representatives told him they were besieged by calls but had little data to give people. Kiessling said he told her they also had no plans to talk to their members about the disruption.
CareFirst responded to CNN’s request for comment.
Kiessling paid for a flu shot and said he would try to get a Covid-19 shot next week.
“How many millions of people are going to go out to get vaccinated, then get discouraged or angry and then not get vaccinated?” he asked.
People who don’t have fitness insurance or who don’t have enough can get a COVID-19 vaccine for free at Walgreens and CVS, as well as through local fitness departments and federally licensed fitness centers through the government’s Bridge Access program.
For the enrolled, the Affordable Care Act requires most plans to cover vaccines without any cost-sharing, so other people shouldn’t even have to pay a copay when they receive it.
But there are some caveats. For new vaccines, such as those introduced this year for seniors and infants who oppose breathing the syncytial virus, or RSV, the law gives insurers up to a year to load vaccines into their plans. For Covid-19 vaccines, new CARES provisions The law has reduced this era to just 15 straight days.
Insurance companies are still within that 15-day timeframe and therefore technically breaking the law, but many other people who have encountered problems with the policies say they don’t understand why those companies weren’t prepared.
“They had a plan for this. It was the most predictable thing that was happening in physical care this year,” said Eric Rogers, 38, of Chicago.
Rogers has a big convention in October and signed up to make an appointment as soon as vaccines are officially recommended. He landed a spot at Walgreens on Sept. 18.
But on the Friday before her appointment, she gets a call from the pharmacy. Workers there had insurance up front, and his company, Blue Cross Blue Shield of Illinois, was not yet covered.
In an emailed statement, Blue Cross Blue Shield of Illinois said such disorders are widespread.
“Most members with an Illinois Blue Cross and Blue Shield fitness plan have access to FDA-cleared COVID-19 vaccines and boosters, and add the latest edition available, occasionally at no cost, as a preventive service when using a network provider’s office or network pharmacy. ,” the saying. Members who have had difficulty accessing the newly approved vaccine deserve to call the visitor service number on their club ID. “
The Blue Cross Blue Shield Association, the national organization that oversees 34 Blue Cross plans across the United States, said its members would meet all requirements.
“BCBS’s plans have been and will continue to be consistent with the preventive services needs indexed in the Affordable Care Act, adding recommendations for the newest Covid-19 vaccines,” said Kelly Parsons, the group’s director of media relations.
Rogers’ pharmacy gave him the option to reschedule his appointment, but he had to postpone it.
“It was worth it to me. I had a very severe Covid crisis a few months before the first vaccines were available. So I have a healthy dose of worry about not having to get it back, or at least making sure I get it back. I don’t have a serious case,” he said.
Rogers said he paid $155. 99 for his vaccine. He will check to provide his receipt for reimbursement, but has high hopes.
“They’re going to tell me, ‘Well, you didn’t follow our instructions,’ and well, I didn’t have instructions,” he said.
Some social media users have complained of similar issues, such as policy delays as part of Cigna, Kaiser Permanente and Florida Blue plans. Kaiser Permanente did not respond to CNN’s request for comment.
A Cigna spokesperson said the company covers new Covid-19 vaccines without cost-sharing and updates its billing systems once new vaccines are approved. The company also said it is in contact with pharmacies to help them with any billing issues.
“COVID vaccines are covered free of charge at any network pharmacy or doctor’s office for Cigna Healthcare visitors. If a Cigna visitor believes their COVID vaccine request was wrongly denied, we encourage them to contact us for a refund,” the company said in a statement. declaration.
A spokesman for Florida Blue, a Blue Cross Blue Shield plan, said some of its members may have struggled because of the recent addition of the new vaccine to their system.
“We apologize for any confusion this may have caused. Florida Blue covers up-to-date vaccines free of charge up to advertising maximum and fully insured members, as well as Florida Blue Medicare members. All affected members contact their pharmacy for reimbursement or to file a claim. . with Florida Blue for reimbursement,” the company said in a statement.
Rogers is still frustrated. ” We’ve been in this situation for several years and were told we have to treat this as a regime issue, but our fitness formula doesn’t know how to deal with this as a regime issue. “he said. .
Marc Ost, co-owner of the independent network pharmacy Eric’s Rx Shoppe in Horsham, Pa. , said he faces three major issues: cost and insurance coverage.
When the government paid for the vaccines, Ost didn’t have to absorb the cost of additional doses that expired before they could be used. From now on, you will have to pay for the doses you sell.
Vaccine maker Moderna allowed it to reserve doses directly, but Pfizer did not. Ost said it was not aware of any network pharmacy providing Pfizer’s Covid-19 injections.
Ost won his Moderna shots on Saturday and his appointments for the 500 doses he won.
His pharmacy began administering Covid-19 vaccines on Monday. Some insurance plans and their pharmacies get advantages. Managers have codes set for billing and there hasn’t been any trouble getting coverage with them, but other companies still don’t cover injections. He said I had to cancel some appointments.
“Unfortunately, we can’t give an injection that costs more than $100 unless they pay us or the patient,” he said.
“Our goal was to give a vaccine to everyone who needed it, but unfortunately it didn’t, at least for the first few days,” Ost said.
He said all of this has led to some confusion and disappointment, especially because other people don’t realize that vaccines are no longer free.
“Patients think it’s covered and also that it’s free, not knowing that there’s a charge for it and that it’s not something our pharmacy can bear,” Ost said.
Four free tests can be carried out by each family upon request through the government’s COVIDTests. gov portal from Monday, September 25.
Proof will be sent through the U. S. Postal Service. The U. S. government is due to open on Oct. 2 and may not be directly affected by a potential government shutdown if Congress doesn’t pass an investment bill until the end of the month.
The government had already introduced loose check kits last winter, but shipments to the online site have been suspended since May to save check stock.
CNN’s Amanda Musa, Deidre McPhillips and Meg Tirrell contributed to this report.