Preparing for COVID-19 vaccine authorization
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COVID-19 vaccines will be an important way to slow the spread of the disease. Helping our customers and members find vaccine information and access vaccines will be our top priority.
While there are several COVID-19 vaccines in late-stage trials and one so far that has applied for EUA approval, there are currently no COVID-19 vaccines authorized by the U.S. Food & Drug Administration (FDA). It is also helpful to know that the FDA has a review process to issue emergency use authorizations before vaccines are authorized for use by the general public. While no vaccine is authorized yet, this is likely to happen soon. It is likely the first FDA-authorized COVID-19 vaccines will require two doses several weeks apart. Those that receive a vaccine that requires two doses will need a second dose in the given time frame following the first dose.
The CDC website is the best resource for COVID-19 information.
When COVID-19 vaccines are authorized by the FDA, members will have $0 cost-share (copayment, coinsurance or deductible), no matter where they get a vaccine, including when two doses are required, as outlined below:
- Employer and Individual health plans*: Members will have $0 cost-share at both in- and out-of-network providers through the national public health emergency period. This applies to fully insured, level funded, and self-funded commercial health plans.
- Medicare plans: Members will have $0 cost-share on vaccines at both in- and out-of-network providers through Dec. 31, 2021.
- Medicaid: For Medicaid individuals in UnitedHealthcare Community Plans, state variations and regulations may apply during this time. Please review the UnitedHealthcare Community Plan website and your state’s site for the latest information. If no state-specific guidance is available, UnitedHealthcare plan guidelines will apply.
*Excludes Short Term Limited Duration plans.
Once a COVID-19 vaccine is FDA authorized, the Centers for Disease Control and Prevention (CDC) will work with state health agencies to determine where the vaccine will be available and will advise on who is first eligible for the vaccine. This will likely be health care and essential workers as well as people at high risk, such as those over 65 years old or with certain medical conditions. Initially, the vaccine will only be available at certain locations. UHC.com will be updated as more information becomes available.
Members who have questions about COVID-19 vaccines should speak with their health care professional to understand what may be best for them and their specific health situation. Members should always show their insurance card and keep their health care professional or physician informed of the COVID-19 vaccines they receive.
Frequently Asked Questions
The COVID-19 vaccine situation is changing quickly. The first vaccines to be FDA-authorized will likely require two doses several weeks apart. Members will need to plan to make sure they get both doses at the right time.
Current vaccine information can be found at the FDA emergency preparedness and response site for COVID-19.
Additional vaccine information can be found at:
Upon authorization, a member’s primary care provider or other health care professional can help a member understand which COVID-19 vaccine might be right for them.
The COVID-19 vaccine serum will initially be paid by the government.
UnitedHealthcare will reimburse administration of FDA-authorized COVID-19 vaccines in accordance with applicable state laws and federal provisions, including the CARES Act and EUA guidance, as outlined below. Updates and additional information will be included in the COVID-19 Vaccine section when new information is released.
For Employer and Individual Health plans*, UnitedHealthcare and self-funded customers will cover the administration of the COVID-19 vaccine with no cost share for in-and out-of-network providers, during the national public health emergency period. Administration fees for in-network providers will be based on contracted rates. Administration fees for out-of-network providers will be based on CMS published rates.
*Excludes Short Term Limited Duration (STLD) plans.
It is important to continue to work together to help reduce the spread of COVID-19 by continuing to practice proper hygiene and protective measures and follow state agency guidance. Members can take the following steps to stay safe:
- Get a flu shot to help protect themselves and their family from the flu.
- Make sure shots and doctor visits are up to date.
- Practice proper hand washing throughout the day, especially after being in a public place, or if you have sneezed or coughed.
- Keep avoiding close contact with physical distancing efforts.
- Clean and disinfect surfaces daily. Remember this includes tables, doorknobs and faucets.
- Cover mouth and nose with a cloth mask when around others.
- Learn more about protection from COVID-19 on the CDC website.
For questions refer to the COVID-19 FAQs or contact your broker or UnitedHealthcare representative.
The information is a summary and is subject to change, as of November 2020. It describes UnitedHealthcare benefits offered to all members in all states. It also includes federal requirements. More benefits may be available in some states and under some plans.