In light of recent action by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS) is announcing that children aged six months to five years with Medicaid and Children’s Health Insurance Program (CHIP) coverage are eligible for COVID-19 vaccinations without cost-sharing. Nearly all people with Medicaid, CHIP, Basic Health Program coverage, self-insured employer-sponsored coverage, and group and individual health insurance coverage can get COVID-19 vaccinations, including boosters, at no cost. People with Medicare pay nothing to receive a COVID-19 vaccination, and there is no applicable co-payment, coinsurance or deductible. People without health insurance or whose insurance doesn’t provide coverage of the vaccination can also get COVID-19 vaccines and their administration, including boosters, at no cost.
The FDA and the CDC recently authorized and recommended both the Pfizer-BioNTech COVID-19 vaccine for children six months through four years of age and the Moderna COVID-19 vaccines for children six months through five years of age, marking a historic milestone in the nation’s fight against the virus.
CMS will support and share the message about the importance of vaccinating the millions of children over the age of six months, including engaging with states, local jurisdictions, and stakeholders to get the latest information on vaccines for children to Medicaid beneficiaries and their families. This effort builds on the work that CMS has already done to require state Medicaid programs to provide coverage for standalone counseling visits about the importance of kids’ vaccination—giving families the support they need to engage with trusted community providers.
Staying up to date with your COVID-19 vaccines, including booster doses, is the best defense against severe illness, hospitalization, and death from the virus. CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations.
Regardless of whether coverage is available without cost-sharing for a COVID-19 vaccination under CMS programs, currently all providers of COVID-19 vaccinations must agree to provide the vaccination at no cost to recipients, as a condition of receiving the vaccine dose from the federal government.
For more information, visit: https://www.cms.gov/newsroom/news-alert/covid-19-vaccinations-covered-without-cost-sharing-eligible-children-aged-six-months-five-years