CMS updates online toolkit with list of COVID-19 vaccines to be covered without cost sharing

CMS has updated its COVID-19 vaccine toolkit to describe the COVID-19 vaccines and boosters currently approved or approved by the Food and Drug Administration (FDA). Group health plans without grandfathering must cover, at no cost, any vaccine approved under an Emergency Use Authorization (EUA) or approved under a Biologics License Application (BLA) by the FDA immediately after the vaccine is authorized or approved (see our Checkpoint article). Coverage must be consistent with the scope of the EUA or BLA for the specific vaccine, including changes that may affect the administration of an additional dose to certain individuals, the administration of booster doses, or the expansion of the demographic age for which the vaccine is approved, enable or approved. The updated toolkit now provides a detailed timeline of the EUAs and other approvals for the COVID-19 vaccines and boosters approved for use in the United States.

Comment from EBIA: While the toolkit is primarily intended for health insurance companies, the explanation of mandatory vaccine coverage also applies to self-insured health plans, and the list of vaccines and boosters that should be covered without cost-sharing can be helpful in planning sponsors. For more information, see EBIA’s Group Health Plan Mandates manual in Section XVI.C “COVID-19: Mandated Coverage of Diagnostic and Preventive Services”) and EBIA’s Self-Insured Health Plans manual in Section XIII.C.11 (” Coverage Mandates Relating to the COVID-19 Pandemic”).

Contributing Editors: EBIA Staff.

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