The New York Times is investigating the costs associated with coronavirus testing, treatment, and vaccination. You can read more about the project and submit your medical bills here.
Biden’s government is reminding doctors, hospitals, pharmacies and insurers that it is illegal to bill patients for coronavirus vaccines, a letter from The Times shows.
The new warning responds to concerns from unvaccinated Americans that they could get a bill with their shot. A recent survey by the Kaiser Family Foundation found that about a third of unvaccinated adults weren’t sure if insurance covered the new vaccine.
“We understand that there are costs associated with administering vaccines – from training staff to storing vaccines,” wrote Xavier Becerra, the health and social services secretary, in a letter to vaccinators and insurers. “Providers cannot bill patients for these expenses, but they can request reimbursement through Medicare, Medicaid, private insurance, or other applicable coverage.”
The letter warns that billing patients could result in state or federal “enforcement action” but does not specify what the penalty would be.
The federal government has written strong consumer protection to ensure patients don’t have to pay for coronavirus vaccines.
In the economic legislation last spring, insurers were prohibited from charging patients co-payments or deductibles for vaccines. The same law also created a fund to cover the cost of vaccinating uninsured Americans.
Layered on top of these legal safeguards are the contracts doctors and hospitals have signed to get vaccines. These documents stipulate that vaccinations cannot charge patients for the service.
The stronger protections seem to have worked. While many patients have come across coronavirus bills for testing, only a handful have come with vaccines.
Still, the rules aren’t foolproof and some patients have been illegally charged. In April, the Inspector General’s Bureau of Health and Human Services released a letter saying it was “aware of patient complaints about fees charged by vendors in obtaining their Covid-19 vaccines.”
Some patients have submitted bills with surprising fees for a Times project that collects patient bills for tests, treatments, and vaccinations. Fees range from $ 20 to $ 850. If you’ve received an invoice for your coronavirus vaccine, please submit it here.
Patients who receive bills for coronavirus vaccines can dispute the fee. Health insurers can turn to their plan and ask why they received a bill when two federal laws – the Families First Coronavirus Response ActResponse and the CARES law – prohibit it.
A small part of health insurance is exempt from the law. These “grandfather” plans existed prior to the Affordable Care Act and are not subject to requirements to fully cover the coronavirus vaccine or other preventive services.
But even these patients are still protected by the contract that the doctors signed to the exclusion of any billing. Doctors can send the outstanding dues to a new Coverage Assistance Fund set up by the Biden government last month specifically to fill gaps in patient care.
Uninsured patients can instruct their providers to bill for the uninsured Covid-19 program that was set up to cover those without insurance.
If an insurer or doctor is unwilling to reverse a bill, patients can seek help from state regulators. State insurance departments usually handle complaints about whether health insurances are not adequately covering medical care, while attorneys general tend to file complaints about possible inappropriate bills from doctors and hospitals.