INDIANAPOLIS — The COVID-19 vaccine is supposed to be free to anyone who wants it. So some 13News viewers are wondering why they are required to show their insurance card when they sign up for the vaccine.
“COVID vaccines are free, yet you are asked to provide health insurance information. Is it true that insurance companies are being charged an 'administrative fee' for your vaccine? What is the purpose of this? Is it illegal to not provide your insurance information?” asked Christopher, a WTHR viewer who lives in Noblesville.
To answer this question from Christopher — and several similar questions we’ve received from other 13News viewers — we checked with the CDC, the Indiana State Department of Health, IU Health and the Kaiser Family Foundation.
What we found
Christopher is correct: COVID-19 vaccines are free. Well, “free” if you don’t take into consideration that U.S. taxpayers will ultimately pay the more than $10 billion cost of developing, manufacturing, distributing and administering the vaccine. Perhaps it is more accurate to say you should not have to pay anything to receive a COVID-19 shot.
On its website, the CDC says, “Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost.” However, the CDC says there is a fee for administering the vaccine, and that fee is supposed to be charged to your health insurer, if you have one.
“Vaccination providers can charge an administration fee for giving someone the shot. Vaccination providers can be reimbursed for this by the patient’s public or private insurance company or, for uninsured patients, by the…Provider Relief Fund. No one can be denied a vaccine if they are unable to pay the vaccine administration,” the CDC states in answering a list of frequently asked questions.
That explains why some vaccine clinics ask for your insurance card. The administration fee — paid by your insurance company — covers the cost of setting up the clinic, storing the vaccine at super-cold temperatures and filling out a lot of paperwork the federal government requires for every coronavirus vaccine that’s administered.
But the Indiana State Department of Health reiterates YOU should not get the bill. ISDH says, “Vaccine providers can bill a patient’s insurance for a fee to administer the vaccine but will not be able to charge the patient.”
Do you legally have to show an insurance card? Health care experts who spoke with 13News VERIFY say the answer to that question is NO.
“Under no circumstances would we turn someone away for not having or showing an insurance card," said Jonathon Hosea, a public relations manager for IU Health, the state's largest healthcare system.
That said, if you do have an insurance card, it’s a good idea to provide it, according to the Kaiser Family Foundation, a nonprofit organization that focuses on national health care issues.
“It is expensive to set up a clinic, store the vaccine and take care of all the data and record keeping. So when they ask you for your insurance card, they are just trying to defray their costs,” KFF senior fellow Karen Pollitz told VERIFY. “It does help the clinic to stay open so it can vaccinate other people and get reimbursed from your insurance company, and insurance can’t turn around and charge you or charge the cost against your deductible.”
Pollitz said it makes sense that some people might be nervous about getting a surprise bill for their vaccination — especially because some Americans received surprise invoices last year after being tested for COVID-19. She said that should not be the case with vaccinations.
“The rules Congress passed on the vaccines are much tighter,” Pollitz said. “There just aren’t loopholes that allow the charges to be passed along to the consumer. If someone tries to charge you for the vaccine, don’t pay it!”
The only way you might see a charge related to a COVID-19 shot is if you get your vaccine from your doctor during a health care visit to address another issue. If, for example, you ask your doctor for a routine physical or to discuss your high blood pressure while you get your vaccine, you will probably receive a bill for that, such as a copay or coinsurance. But you should only be charged for the visit, not for the actual vaccine or for administering the shot.
So we can verify insurance companies ARE being charged a fee to cover the cost of administering the COVID-19 vaccine. But it is not mandatory to show your insurance card to get a vaccine — although there's really no reason not to since insurance companies cannot pass along the cost of administering the vaccine to patients.
Have a question for our VERIFY Team? Send us an email at VERIFY@wthr.com.