Many Americans remain confused about whether they need to pay for COVID-19 tests, vaccines, and treatments—and if so, how. For those without health insurance, this is a particularly vital concern. 

To help answer some of the most pressing questions, the U.S. Department of Health and Human Services (HHS) website provides information about the CARES Act Provider Relief Fund, as well as the Centers for Disease Control and Prevention’s COVID-19 Vaccination Program.*

How the COVID-19 Vaccination Program assists patients

According to the program, healthcare providers:

• Must give you a COVID-19 vaccine, regardless of your health insurance coverage or network status 
• May seek reimbursement from a program or plan that covers COVID-19 vaccine administration fees for you, such as:
  • Your private insurance company
  • Medicare or Medicaid reimbursement
  • Health Resources and Services Administration (HRSA) COVID-19 Uninsured Program for non-insured vaccine recipients
• Can’t seek any payment from you for the COVID-19 vaccine or its administration
• Can’t charge you for an office visit if getting a COVID-19 vaccination is the only reason for your visit
• Can’t require you to receive a COVID-19 vaccination

You may report violations of these requirements to the Office of the Inspector General of the U.S. Department of HHS, by calling 1-800-HHS-TIPS or going to their website, tips.hhs.gov.

If you are insured

Private insurers are typically required to waive an insured’s cost-sharing payments for COVID-19 testing, vaccine administration, and certain related services. Some private insurers, such as Humana, Cigna, UnitedHealth Group, and Blue Cross Blue Shield, have waived cost-sharing payments for COVID-19 treatment, as well.  

If you are insured and seek COVID-19 treatment from an out-of-network provider that has received distributions from the Provider Relief Fund, the provider has agreed not to seek out-of-pocket payments greater than what you would have paid to an in-network provider.

If you are uninsured

If you are uninsured and received COVID-19-related testing, treatment, vaccination, your doctor may have submitted a claim to the HRSA for reimbursement. If you were charged for COVID-19 testing or treatment services and the bill shows HRSA reimbursement for those services, contact your doctor to discuss how best to resolve your bill.

If you already paid the bill and the provider received funding for your care through the program, the provider must return your money to you. If your doctor didn’t submit a bill for your COVID-19-related testing and/or treatment to the program or if the care wasn’t eligible for reimbursement, you may be responsible for the full cost of testing or care. 

Please note that providing your immigration status is not mandatory for the claims process.  Inability to provide a social security number (SSN), state of residence, or driver’s license will not disqualify claims for reimbursement. This information is only intended to help determine your eligibility for the program (confirm that you are uninsured). By law, the HRSA Uninsured Program can only reimburse uninsured patients for eligible COVID-19-related services.

*U.S. Department of Health & Human Services. (2021, Mar. 17). CARES Act Provider Relief Fund: For Patients. https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-patients/index.html  

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.