:max_bytes(150000):strip_icc()/GettyImages-1344723070-6f62d1c477ff4e31b8dbdf1205e463ca.jpg "If You Want a Covid Shot Covered by Insurance, It May Pay to Get It This Week")
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Key Takeaways
- The Centers for Disease Control and Prevention (CDC) could soon make it more difficult for older adults to get COVID-19 vaccines covered by insurance.
- The Advisory Committee on Immunization Practices (ACIP) is expected to consider raising the age older adults are recommended to receive the vaccine to 75 from 65 when the group meets Friday.
- ACIP’s members were appointed by Health and Human Services Secretary Robert F. Kennedy Jr., who has publicly criticized vaccines.
- Insurers are not required to cover vaccines for people outside the CDC’s recommended group, though some companies have pledged to continue coverage through 2026.
Older adults who want the latest COVID-19 booster vaccine may want to get to a pharmacy sooner rather than later.
That’s because the pool of people who are “recommended” to receive the vaccine could shrink after a CDC meeting on Friday. The agency’s Advisory Committee on Immunization Practices is considering raising the age at which people are recommended to receive a COVID-19 vaccine from 65 and older to 75 or older, according to reporting from the Washington Post. The committee could also eliminate age as a recommendation category entirely.
Insurance companies are only legally required to cover vaccines for populations that the CDC recommends receive them. Typically that’s children, the elderly, and those with other risk factors. ACIP eliminating age as a category would make it harder for those without a separate risk factor to get their COVID-19 booster covered by insurance.
ACIP’s members were all appointed by Health and Human Services Secretary Robert F Kennedy Jr., who has been openly critical of vaccines. Multiple ACIP members have expressed similar views. If ACIP does change its recommendations, they would need to be approved by the CDC’s acting director, another Kennedy Jr. appointee, a spokesperson for Health and Human Services (HHS) told Investopedia. It’s unknown how long it takes for proposed changes to be approved and enacted.
Insurance Group Says It Will Keep Coverage
People 65 and older with insurance through Aetna, Cigna, Blue Cross Blue Shield (in certain states), and some other providers should still be able to have their COVID-19 vaccines covered, at least through next year.
AHIP, a health insurance trade organization that counts those companies as members, said this week that its health plans will stick with ACIP recommendations as of September 1, rather than adopt potential changes. It said it will cover people for flu and COVID-19 vaccines through 2026, so those consumers won’t have to pay anything for them.
“While health plans continue to operate in an environment shaped by federal and state laws, as well as program and customer requirements, the evidence-based approach to coverage of immunizations will remain consistent,” the group said.
CVS and Walgreens Don’t Offer COVID Vaccines in Every State
In most states, you can get the 2025-2026 vaccine at CVS Health (CVS) and Walgreens (WBA) without a prescription. But there are more than a dozen states where a prescription is required for one or both.
In Florida, where CVS requires a prescription, Walgreens does not currently offer the vaccine. The company’s website said “vaccines will be available at pharmacies as soon as ACIP issues eligibility guidance.”
The Bottom Line
The availability of COVID-19 vaccines could be changing soon. A CDC advisory group will reportedly consider raising the age that the CDC recommends the vaccine to 75 from 65, meaning insurers wouldn’t have to cover it at no cost. However, AHIP has pledged that its member companies, which include Aetna, Cigna, and some states’ Blue Cross Blue Shield branches, will continue to provide coverage through 2026.
