Why have these latest COVID vaccine rollouts seemed so different this time? Do I have to pay for it now?
If you’re wondering why the new COVID vaccine took a while to become widely available back in the fall, or why you heard reports of some people with Medicare being charged over $150 to receive the new vaccine at a pharmacy back then, it’s because of one major change that started in 2023: The federal government has stopped footing the bill for COVID vaccines.
The shots have now transitioned into the traditional health care market. So for most people with health insurance, their insurer will now cover the cost of getting the new COVID vaccine direct, much like your plan might cover your flu shot — and this is why many county public health officials urge people to first seek out the new vaccine via their health care provider. (It’s also why those county-run vaccination sites that were so common at the height of the pandemic now no longer exist on the same scale, and will primarily be targeted toward folks without insurance.)
And if you’re one of those people who don’t have insurance, the White House will still cover the costs of your COVID vaccines through a federal program until December 2024. But this means you may now have a narrower choice of places to get it.
The bottom line is that your updated vaccine should still be free, the way COVID vaccines have been throughout the pandemic. But if you have health insurance, it’s still important to be extra sure you’re asking for your COVID shot somewhere that accepts that insurance — especially if you’re going to a pharmacy. In other words, you now have to think about all the potential costs and insurance wrangling that you didn’t have to consider for several years when it came to your COVID care.
Why can’t I get my new COVID vaccine at a pharmacy if I have Kaiser?
Another reason you might potentially be charged for your new COVID vaccine, or denied the shot if you refuse to pay out of pocket: if you get your health care through a health system like Kaiser Permanente.
Usually, if you have health insurance, you should be able to give your insurer’s details at a pharmacy vaccination appointment to have the cost of your shot billed to them. Health systems like Kaiser are the exception to this, and so you almost certainly won’t be able to get your new COVID vaccine at a pharmacy like CVS or Walgreens, the way you can’t get your flu shot covered by Kaiser at a pharmacy either.
Instead, Kaiser Permanente has recommended members receive their updated COVID vaccinations at a Kaiser, where the cost of the new COVID vaccines will be covered “according to the coverage of routine vaccinations provided by members’ plan benefits when administered at a Kaiser Permanente facility,” a spokesperson told KQED in 2023. This has also meant that those who have health insurance through Kaiser have faced a slightly longer wait for their new COVID vaccine than folks with other types of insurance, unless you’re prepared to pay large costs up-front. CVS, for example, charges $190.99 for the new COVID vaccine “if CVS is not in network with your insurance plan.”
A Kaiser spokesperson told KQED that “we are updating our processes and systems to reflect the new CDC recommendation” for people age 65 and older, and that Kaiser expects to begin administering this extra dose “in most areas we serve in California by March 8, and possibly earlier in some locations.”
Is the Novavax COVID vaccine available as well as Moderna and Pfizer’s new vaccines?
Yes: After a period of FDA review, the Novavax COVID vaccine was authorized in 2023 for people age 12 and older who have not already been vaccinated with the new Moderna or Pfizer COVID vaccine.
Unlike Pfizer and Moderna’s new COVID shots, the Novavax vaccine is a non-mRNA, protein-based vaccine. One reason some people choose the Novavax vaccine is based on aftereffects from getting the shot — as Science has reported, Novavax “appeared less likely than mRNA shots to cause side effects like headache and fatigue” in clinical trials.
What’s the cost of the vaccine, whether I have insurance or not?
This is the first time during the COVID pandemic that the federal government isn’t footing the bill for these vaccines. Now that the White House’s public health emergency for COVID has ended, these COVID vaccines are no longer purchased or distributed by the federal government. Now, COVID shots have transitioned to the traditional health care market and will be increasingly considered the way that other preventative vaccines, like flu shots, are.
For most people with health insurance, their insurer will cover the cost of getting the new COVID vaccine, including Medicare.
But if you don’t have insurance, the White House will still cover your COVID vaccines through a federal program called the Bridge Access Program, which lasts through December 2024. This means you’ll now have a narrower choice of places to get your COVID vaccine because you’ll have to make sure the vaccination location you’ve chosen participates in the Bridge Access Program.
The CDC says people without insurance will be able to visit the federal government’s vaccines.gov site to find a location where they can get the new COVID vaccine for free. When searching for a vaccination location near you using this site, be sure to check the box marked “Participating in Bridge Access Program.”
I’m 65 or older and I had COVID recently. Do I have to wait before getting my extra COVID vaccine?
Yes, the CDC advises that you “may consider delaying vaccination by 3 months from symptom onset.” And if your case was asymptomatic, use the date of your positive test instead of the onset of your symptoms.
This means, that if you had a COVID infection after early December 2024, you may wish to delay getting your new COVID vaccine until you hit your three-month mark. But as with all matters relating to your health, it’s best to speak directly to your healthcare provider about the best option for you.
Where can I find an extra COVID vaccine this spring if I’m age 65 or older?
Don’t assume you’ll be proactively contacted about getting an extra dose of the updated COVID vaccine.
Remember that a certain location may only be offering a certain brand of the new vaccine, whether that’s Moderna, Pfizer, or Novavax. So be sure that the location you’re walking into or making an appointment for offers the type of updated vaccine you need or want.
1. Find an extra COVID vaccine dose through a local pharmacy
For future reference, pharmacies are usually the first place new vaccine shots become available when announced because pharmacies take their cue from the federal government, not the state. Several pharmacy chains, including CVS and Walgreens, are now offering online appointments for the new additional COVID vaccine dose for people age 65 and older, and some may also accept walk-in appointments with no prescheduling required.
If you have health insurance like Medicare, you should be able to give your insurer’s details at a pharmacy vaccination appointment to have the cost of your shot billed to them. One big exception to this: If you get your health care through a health system like Kaiser Permanente, you almost certainly won’t be able to get your new COVID vaccine for free (i.e., covered by your insurance) at a pharmacy like CVS or Walgreens, the way you can’t get your flu shot covered by Kaiser at a pharmacy either.
Ultimately, if you are a member of a health system like Kaiser and are unsure about what your health insurance covers, reach out to your provider to check if you will need to obtain your new COVID vaccine through them, in order to have it covered.
If you don’t have health insurance, some pharmacies will be offering appointments that don’t require health insurance. Visit the federal government’s vaccines.gov website to search for a location near you, and be sure to check the box marked “Participating in Bridge Access Program,” (the name of the federal program that’s funding new COVID vaccines for uninsured people).
2. Find an extra COVID vaccine dose through your health care provider, when available
If you have health insurance, check with your health care provider to see whether they can offer you an updated COVID vaccine.
If you don’t have health insurance but get medical care through a city- or county-run provider, you should check with that location to see whether they can offer you the new COVID vaccine.
In addition to trying to talk with your health care provider directly, check the website of your provider to see whether it’s offering the ability to make appointments, and sign up for their vaccine notifications if that’s an option.
3. Find an extra COVID vaccine dose through vaccines.gov
Visit the federal government’s vaccines.gov website to see when appointments for the new updated COVID vaccine in or near your zip code become available. Right now, the majority of Bay Area appointments visible on vaccines.gov appear to be at pharmacies.
Using vaccines.gov is also the CDC’s recommendation for finding a vaccination site if you’re uninsured. When searching for a vaccination location near you using this site, be sure to check the box marked “Participating in Bridge Access Program,” because that’s the name of the federal program that’ll be funding new COVID vaccines for uninsured people.
4. Find an extra COVID vaccine dose through My Turn
Throughout the pandemic, My Turn has been the state’s site for all Californians to schedule vaccination appointments or find walk-in locations, regardless of health insurance status.
Because the new COVID vaccines are now being distributed through the traditional health care market, My Turn’s services are now geared primarily toward uninsured people. The site’s homepage says that “if you don’t have insurance or your plan doesn’t cover routine vaccinations, My Turn will provide a list of locations that offer vaccines at no cost for the uninsured.”
If you visit the My Turn page, select “Make an Appointment.” My Turn will ask for your information, and the ZIP code or location you’d like to use to search for vaccine appointments. You can give your home location, or input other locations to see which sites might be available farther away.
