Privatized Vaccine Distribution Sparks Confusion, Payment Challenges

As the rollout of the updated COVID-19 vaccine progresses, some individuals have been surprised by requests for upfront payments ranging from $150 to $200. 

The U.S. government has shifted responsibility for vaccine distribution, administration, and payment coverage to private companies, including vaccine manufacturers, pharmacies, and insurance plans.

In September, approximately 4 million people received updated doses of the Pfizer Inc (NYSE: PFE)/ BioNTech SE (NASDAQ: BNTX) or Moderna Inc (NASDAQ: MRNA) vaccines, with 12 million doses shipped, Reuters noted, citing data from the U.S. Department of Health and Human Services. 

Kaiser Permanente said they have limited out-of-network vaccine coverage, except in California. Members can get reimbursed for COVID-19 vaccines from non-Kaiser providers until November 11.

The privatized vaccine distribution system has led to upfront payment requests, which the government previously covered during the public health emergency declaration. 

Health insurance plans are now legally obligated to cover the vaccine costs, while pharmacies and healthcare providers order shots directly from manufacturers.

Both Pfizer and Moderna have stated that they have shipped millions of doses, with Pfizer delivering over 10 million doses, including more than 1 million pediatric doses.

However, some pharmacy chains, such as CVS Health Corp (NYSE: CVS), have reported ongoing delivery delays from their wholesalers, while Walmart Inc (NYSE: WMT) and Walgreens Boots Alliance Inc (NASDAQ: WBA) are actively offering updated COVID-19 shots as supplies become available. Major distributors like McKesson Corporation (NYSE: MCK) and Cardinal Health Inc (NYSE: CAH) have also acknowledged some short-term shipping delays.

In response to reports of payment issues, health insurance executives met with government officials and assured that plans are reimbursing vaccines given by in-network providers. Nevertheless, some individuals have reported that pharmacies are not covering the new vaccine doses at their locations.

Independent pharmacists are grappling with the added burden of covering vaccine costs.

Disclaimer: This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors.