Important information from Congressman Donald Norcross...
I am pleased to inform you that through the Centers for Medicare and Medicaid Services (CMS), eligible Medicare recipients will be able to receive the COVID-19 vaccine at no cost as soon as it becomes available.
The CMS is guaranteeing that all FDA approved COVID-19 vaccines will be covered under Medicare as a preventative medicine. Additionally, CMS will be expanding additional Medicare hospital payments to support Medicare patients' access to critical COVID-19 treatment therapies.
More information on the CMS guidelines can be found here.
For COVID-19 vaccine resources, click here.
For COVID-19 billing information, click here.
More information on coverage
As a condition of receiving free COVID-19 vaccines from the federal government, providers will be prohibited from charging consumers for administration of the vaccine. To ensure broad and consistent coverage across programs and payers, the toolkits have specific information for several programs, including:
- Beneficiaries with Medicare pay nothing for COVID-19 vaccines and their copayment/coinsurance and deductible are waived.
- Medicare Advantage (MA):
- For calendar years 2020 and 2021, Medicare will pay directly for the COVID-19 vaccine and its administration for beneficiaries enrolled in MA plans. MA plans would not be responsible for reimbursing providers to administer the vaccine during this time. Medicare Advantage beneficiaries also pay nothing for COVID-19 vaccines and their copayment/coinsurance and deductible are waived.
- State Medicaid and CHIP agencies must provide vaccine administration with no cost sharing for most beneficiaries during the public health emergency. Following the public health emergency, depending on the population, states may have to evaluate cost sharing policies and may have to submit state plan amendments if updates are needed.
- Private Plans:
- CMS, along with the Departments of Labor and the Treasury, is requiring that most private health plans and issuers cover a recommended COVID-19 vaccine and its administration, both in-network and out-of-network, with no cost sharing. The rule also provides that out-of-network rates cannot be unreasonably low, and references CMS’s reimbursement rates as a potential guideline for insurance companies.
- For individuals who are uninsured, providers will be able to be reimbursed for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA).
Additional COVID Resources
- The New Jersey Government has a COVID-19 website with live updates and resources here.
- All residents with questions or concerns about COVID-19 and resources available to them can call 2-1-1. NJ 211 is New Jersey’s statewide, comprehensive, information and referral service operated by United Ways of New Jersey.
- Residents call also text NJCOVID to 898-211 to receive text information and stay informed. To receive live text assistance, residents can text their zip code to 898-211.
- The Center for Disease Control has a resource page here.
- My office has a resource page here.
- Make sure to follow me on Facebook and Twitter, and visit my website for updates.
- To receive updates from my office, sign up here.
It is an honor to serve this community and we will get through this, together.
Member of Congress