​COVID-19 (Coronavirus): Vaccine coverage and reimbursement

November 11, 2021

This article was revised on November 11, 2021.

There are different reimbursement rules for approved COVID-19 vaccines, boosters, and their administration, depending on whether the member has a Commercial or Medicare Advantage plan.

Commercial:

  • The vaccine and booster will be distributed by the U.S. Government at no charge and will not be eligible for reimbursement by Independence.

  • Independence will cover the administration of approved COVID-19 vaccines and boosters as a preventive service with $0 cost-share (i.e., copayment, deductible, and coinsurance). We will reimburse the vaccine and booster administration cost as a preventive service.

Medicare Advantage:

  • The COVID-19 vaccine and booster has been identified as meeting Medicare's significant cost threshold. Both the vaccine (and booster) and administration of the vaccine will be processed through the local Medicare Administrative Contractor (MAC) for calendar years 2020 and 2021. To find your local MAC, click here.

  • Providers must submit all claims for approved COVID-19 vaccines, boosters, and associated costs to the local MAC. Claims should not be submitted to Independence.

  • Medicare Part B – not the Medicare Advantage Organization – will cover the administration of approved COVID-19 vaccines and boosters.

The procedure codes for the vaccine and administration can be found in the News Articles posted on our Medical and Claim Payment Policy Portal:

Independence is committed to providing our members with access to the care they need during the COVID-19 pandemic. We encourage all Independence members and providers to visit our dedicated COVID-19 webpage regularly for the latest news and updates. We will continue to evaluate member needs as the situation changes.

Learn more

Read the full series to learn more about COVID-19 vaccines and administration requirements.