While most vaccines are covered under Medicare Part B, the RSV vaccine is covered under Part D. The 16 million Medicare enrollees without Part D coverage may have to pay for the vaccine out of pocket, according to the New York Times.
Coverage for the vaccine varies among private insurers, according to The New York Times. In June, the CDC’s Advisory Committee on Immunization Practices said adults 60 years and older “may” receive the RSV vaccine, rather than “should.”
The RSV vaccine does not yet appear on the CDC’s adult immunization schedule. A spokesperson for Blue Cross Blue Shield told The New York Times that until the vaccine appears on the schedule, “it is up to each BCBS plan to decide if they want to cover.”
Read The New York Times’ full report here.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 17–19 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
