Clarification Regarding Charging Recipients for COVID-19 Vaccinations

Apr 15, 2022

This message is a follow up to our March 22, 2022 message announcing the end of the U.S. Health Resources and Services Administration (HRSA) funding for COVID-19 testing, treatment, and vaccination services for uninsured individuals and reminding providers of MaineCare’s COVID-19 uninsured benefit.

As a reminder, COVID-19 vaccines are available for everyone ages 5 years and older, regardless of health insurance or immigration status, at no cost. When administering a COVID-19 vaccination, providers cannot:

• Charge someone for a vaccine or for any administration fees, copays, or coinsurance associated with administering a vaccine
• Charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination
• Deny a vaccination to anyone who does not have health insurance coverage, is underinsured, or is out of network
• Require additional services in order for a person to receive a COVID-19 vaccine; however, additional health care services can be provided at the same time and billed as appropriate

COVID-19 vaccination providers may seek appropriate reimbursement for a vaccine administration fee from the recipient’s plan or program such as MaineCare, Medicare, or private health insurance but cannot charge the vaccine recipient the balance of the bill.

See the U.S. Centers for Disease Control and Prevention (CDC) COVID-19 webpages about free COVID-19 vaccinations for the public and COVID-19 vaccination program provider requirements and support for more details.

Please contact your Provider Relations Specialist with questions about the MaineCare COVID-19 uninsured benefit.