Key Takeaways
- The Facilities for Illness Management and Prevention (CDC) might quickly make it tougher for older adults to get COVID-19 vaccines coated by insurance coverage.
- The Advisory Committee on Immunization Practices (ACIP) is predicted to contemplate elevating the age older adults are beneficial to obtain the vaccine to 75 from 65 when the group meets Friday.
- ACIP’s members have been appointed by Well being and Human Companies Secretary Robert F. Kennedy Jr., who has publicly criticized vaccines.
- Insurers usually are not required to cowl vaccines for folks outdoors the CDC’s beneficial group, although some firms have pledged to proceed protection by means of 2026.
Older adults who need the newest COVID-19 booster vaccine could wish to get to a pharmacy sooner quite than later.
That’s as a result of the pool of people who find themselves “beneficial” to obtain the vaccine might shrink after a CDC assembly on Friday. The company’s Advisory Committee on Immunization Practices is contemplating elevating the age at which individuals are beneficial to obtain a COVID-19 vaccine from 65 and older to 75 or older, based on reporting from the Washington Submit. The committee might additionally remove age as a suggestion class totally.
Insurance coverage firms are solely legally required to cowl vaccines for populations that the CDC recommends obtain them. Usually that’s kids, the aged, and people with different danger components. ACIP eliminating age as a class would make it tougher for these with out a separate danger issue to get their COVID-19 booster coated by insurance coverage.
ACIP’s members have been all appointed by Well being and Human Companies Secretary Robert F Kennedy Jr., who has been brazenly essential of vaccines. A number of ACIP members have expressed comparable views. If ACIP does change its suggestions, they’d should be accredited by the CDC’s performing director, one other Kennedy Jr. appointee, a spokesperson for Well being and Human Companies (HHS) advised Investopedia. It’s unknown how lengthy it takes for proposed adjustments to be accredited and enacted.
Insurance coverage Group Says It Will Hold Protection
Folks 65 and older with insurance coverage by means of Aetna, Cigna, Blue Cross Blue Protect (in sure states), and another suppliers ought to nonetheless be capable of have their COVID-19 vaccines coated, at the very least by means of subsequent yr.
AHIP, a medical insurance commerce group that counts these firms as members, stated this week that its well being plans will persist with ACIP suggestions as of September 1, quite than undertake potential adjustments. It stated it is going to cowl folks for flu and COVID-19 vaccines by means of 2026, so these shoppers will not should pay something for them.
“Whereas well being plans proceed to function in an setting formed by federal and state legal guidelines, in addition to program and buyer necessities, the evidence-based strategy to protection of immunizations will stay constant,” the group stated.
CVS and Walgreens Do not Supply COVID Vaccines in Each State
In most states, you may get the 2025-2026 vaccine at CVS Well being (CVS) and Walgreens (WBA) with out a prescription. However there are greater than a dozen states the place a prescription is required for one or each.
In Florida, the place CVS requires a prescription, Walgreens doesn’t presently supply the vaccine. The corporate’s web site stated “vaccines will likely be accessible at pharmacies as quickly as ACIP points eligibility steerage.”
The Backside Line
The supply of COVID-19 vaccines could possibly be altering quickly. A CDC advisory group will reportedly take into account elevating the age that the CDC recommends the vaccine to 75 from 65, that means insurers would not should cowl it without charge. Nevertheless, AHIP has pledged that its member firms, which embrace Aetna, Cigna, and a few states’ Blue Cross Blue Protect branches, will proceed to supply protection by means of 2026.
