COVID-19 (Coronavirus): Vaccine coverage and reimbursement

March 10, 2021

This article was revised on March 10, 2021.

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

Commercial:

  • The vaccine 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 as a preventive service with $0 cost-share (i.e., copayment, deductible, and coinsurance). We will reimburse the vaccine administration cost as a preventive service.

Medicare Advantage:

  • The COVID-19 vaccine has been identified as meeting Medicare's significant cost threshold. Both the vaccine 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 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.

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.