BY NOW, YOU’VE probably gotten your Covid vaccine, and maybe a booster or two.
You’re not alone. About 80 percent of Americans have received at least one dose of the vaccine, and nearly 70 percent are fully vaccinated, meaning you’ve had both doses of the Pfizer or Moderna shots or received the Johnson & Johnson single-shot vaccine, according to the Centers for Disease Control and Prevention. But just 16.7 percent have gotten Covid boosters.
Health experts say you’ll probably have to get updated Covid shots every year, kind of like a flu shot. So far, the vaccines and boosters have been free, but that might change soon when the Covid-19 public health emergency (PHE) ends on May 11.
More From Men’s Health
In March 2020, President Donald Trump declared the national PHE to help defeat Covid-19. It made billions of federal dollars available to provide people with Covid tests, treatments, and vaccines at no cost.
The shift out of the PHE won’t be abrupt, however, says Georges Benjamin, M.D., executive director of the American Public Health Association.
“There is still a fair amount of free government-purchased testing materials, and enough vaccines and antivirals,” he adds. As long as these supplies last, you can still get a vaccine for free.
Once those stocks run out, you’ll have to rely on your health insurance to cover Covid vaccines. If you don’t have insurance, you’ll have to pay for them yourself.
To lessen the blow to people who don’t have insurance, President Biden recently announced a new $1.1 billion program to help the uninsured access Covid vaccines and treatments through their local pharmacies and health centers.
Generally, “People should be able to get vaccinated pretty easily,” Dr. Benjamin says. Here’s what you need to know about getting a Covid vaccine once the PHE ends.
Will Your Insurance Cover Covid Vaccines and Boosters?
Most private insurance plans will cover Covid vaccines and boosters, says Nancy Nielsen, M.D., Ph.D., senior associate dean for health policy at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences.
Insurance companies will likely cover vaccines without a copay, because they’re considered a preventive health service, according to the U.S. Department of Health and Human Services. But that could vary depending on your plan or change down the road.
“The important thing is to check with your insurer and see,” Nielsen says. “Ask them what’s going to be the impact on you when the emergency ends on May 11.”
Medicare will cover Covid vaccinations without a copay or cost-sharing through September 30, 2024, according to HHS.
What If You Don’t Have Insurance?
Many people were allowed to get Medicaid during the pandemic. States received enhanced federal funding to keep people enrolled in state Medicaid programs through the end of the PHE, according to the Kaiser Family Foundation.
But starting April 1, states began redetermining the eligibility of Medicaid recipients and started applying pre-pandemic eligibility criteria. The result is that 5 million to 14 million people could lose Medicaid coverage nationwide and be left uninsured, according to KFF.
“For anybody who’s on Medicaid now, but won’t be eligible, it’s on you to make sure you don’t get surprised,” Dr. Nielsen says. “That’s a big risk.”
Dr. Benjamin suggests contacting your state Medicaid agency to make sure your contact information is up-to-date and to find out when they’re making eligibility redeterminations.
Even if you’re uninsured (because you lose Medicaid or for another reason), you might still be able to get vaccinated for free. Dr. Nielsen says as long as the federal government has a stockpile of the vaccines, you can access them.
Dr. Benjamin adds that some local community clinics could offer shots, too. Plus, the Biden administration announced a plan to ensure the uninsured can access vaccines, but details haven’t been released.
If you stay on Medicaid, states are required to provide coverage for Covid testing, treatments, and vaccines through September 30, 2024, according to HHS. Once that deadline passes, coverage will vary by state.
How Much Will Covid Shots Cost?
It’s hard to say just yet exactly how much Covid vaccines will cost, Dr. Nielsen says.
Some estimates suggest that, commercially, the shots could cost $110 to $130 per dose. But it’s possible that insurance companies and the federal government could negotiate lower rates.
Do I Need a Covid Booster Every Year?
Earlier this year, the Food and Drug Administration suggested that most people should get an updated Covid shot every year to guard against new variants of the virus.
“Everybody should be vaccinated,” Dr. Nielsen says. “We may need new vaccines and boosters. We know that the immunity wanes after about four to six months. So we’re probably going to be in a situation where it will be recommended that you get a yearly Covid shot, just like the flu vaccine.”
Follow the public health recommendations in your area through your local health department and keep up with CDC recommendations about boosters, Dr. Benjamin urges.
“We’re going to have to live with this virus,” Dr. Nielsen says. “If the virus mutates and becomes either more deadly or more transmissible, we have to listen to the experts about whether we need a booster.”
Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.
