As we head into fall, a crucial update from the Centers for Disease Control and Prevention (CDC) has sent shockwaves through the public. The Food and Drug Administration (FDA) recently ended a program that provided free COVID-19 vaccines as of August 2024. This change means that many individuals may now face unexpected costs for vaccination, prompting urgent advice to verify health insurance coverage before scheduling a shot.

Take it from Ed Pliml, who was stunned to discover that his new COVID-19 booster shot would set him back more than $100. He recounted his experience to CBS News Chicago, highlighting the complications and confusion he encountered while trying to receive the vaccination. In previous years, securing a shot was a straightforward process, but this summer, he faced hurdles when visiting his local pharmacy, which previously offered immunizations for free.

“Initially, I thought it would be just as easy as every other year,” Pliml reflected. However, when he arrived for his shot, the pharmacist informed him that while the flu vaccine was covered by his insurance, the COVID vaccine was not—a shocking revelation.

Considering this change, many patients may find themselves unprepared for potential out-of-pocket expenses. As Sume Chakkalakel, a pharmacist at CVS, explains, “The COVID-19 vaccine is available at no cost with most insurances.” But patients must ensure they visit an in-network pharmacy to avoid hefty fees, which could be around $200 at out-of-network locations.

This shift signifies an essential reminder: have your health insurance plan handy before heading out for your vaccination. It’s also critical to be aware of the specific names of the vaccines—Pfizer's is called Comirnaty, while Moderna's is recognized as Spikevax.

Pliml shared his frustration with the miscommunication he received from his Medicaid provider. "I still have no idea what is going on," he said, highlighting the confusion surrounding vaccine access.

In response to inquiries, BlueCross Blue Shield of Illinois acknowledged that “coverage and networks may vary” and encouraged members to consult their member ID card for accurate information regarding their vaccine coverage.

For residents in Chicago, there’s still hope; the Chicago Department of Public Health plans to provide free COVID shots starting in October at their immunization clinics. Those with insurance—be it private, Medicare, or Medicaid—should generally expect coverage for these vaccines.

Pharmacists like Chakkalakel are hopeful that information about the new vaccination process will reach patients in the coming weeks, especially as we face colder months ahead.

To answer some critical questions:

Who should get the new COVID-19 booster?

The current recommendation is for everyone aged six months and older.

Why is it necessary to get boosted again?

Immunity to the virus tends to diminish over time, making boosters essential.

Can you receive the flu and COVID-19 vaccines at the same time?

Absolutely! Many patients have successfully received both shots in the same visit.

For those uninsured or underinsured, CDPH is committed to providing vaccinations at its three immunization clinics, welcoming walk-ins but encouraging prior registration for the best experience. They also operate a Vaccine for Children Program for those under 18 who lack healthcare coverage.

As the virus continues to evolve, staying informed and proactive about your vaccination status is more important than ever. Don’t let unexpected costs catch you off guard—check your insurance, avoid surprises, and protect yourself this flu season!