Many New Yorkers have begun searching for the latest COVID-19 vaccines tailored to this year’s major coronavirus variants. US Food and Drug Administration and Centers for Disease Control and Prevention Signed off on the shot last week.
But while some people aren’t having problems, other New Yorkers are experiencing last-minute appointment cancellations at chain pharmacies because supplies haven’t arrived yet or because of insurance issues.
Insurance coverage for vaccines is not an issue. Vaccines should be free to everyone, either through their health insurance or through the federal government. bridge access program, was released last Thursday. CDC Recommendation Most health plans are required to cover vaccines recommended by the CDC under the Affordable Care Act, which is the most up-to-date vaccination program for everyone six months of age and older. Anyone who is uninsured or has self-pay can rely on the Bridge Access Program, which will run through the end of the year.
But Brooklyn resident Hannah Beh said she paid $190 for a Moderna shot at CVS on Saturday. About 15 minutes before her 10:30 a.m. appointment, she received a call from a pharmacy in downtown Brooklyn informing her that her appointment had been canceled because her insurance plan had not yet approved coverage for the vaccine. said. Bae said she was eager to get the shot one way or another, but she ended up putting it on a credit card.
“As far as I know, I have never been infected with the new coronavirus. I only have the protective effect of the vaccine I received previously, so I feel very vulnerable,” Bae said. “Everyone I know is currently infected with or has been exposed to COVID-19.”
Bay first learned about the Bridge Access program after she “angrily posted” online about her experience, but she said no one at CVS mentioned it to her. And state health officials say CVS should have billed Bae without issue, instead of charging her. They explained that the headaches stem from delays in insurance renewals and stressed that no one should have to pay out of pocket.
Meanwhile, city-run sites are coming online next to pharmacy chains as this vaccine rollout differs from that of previous versions. Manufacturers Moderna and Pfizer-BioNTech are sending doses directly to pharmacies and health care providers, rather than distributing supplies through the federal government. Major pharmacy chains were among the first to receive the vaccine, but publicly run sites, nonprofit organizations and some independent pharmacies are also waiting.
Insurance issues cause confusion
Bae is enrolled in the New York State Essential Plan, a publicly funded insurance program for low-income people overseen by the New York State Department of Health. She enrolled in her own plan through Empire Blue Cross Blue Shield. All Medicaid and Essential Plan policies began covering the latest coronavirus vaccines starting Sept. 11, Department of Health spokesperson Daniel D’Souza said.
However, D’Souza said the Ministry of Health acknowledged that coverage of the new vaccine was delayed because privately run medical databases did not update billing codes for insurance companies and pharmacies in a timely manner.This is a reported issue Nationwide expansion has been affected..
DeSouza added that for Essential Plan subscribers, “the plan provides refunds to consumers in the event of improper charges.” However, it is unclear whether the insurance companies administering the insurance will keep that promise.
Stephanie Dubois, a spokeswoman for Anthem, which operates Empire, said members who didn’t get a free shot last week “can get it again for $0 out of pocket.” Asked whether her insurance company would reimburse members who had already paid out of pocket, she did not respond.
Jennifer Bristol, a Medicaid member, had similar problems to Bae. DeSouza, the state health officer, said the latest COVID-19 vaccine Medicaid code went into effect last Friday, Sept. 15, and the state distributed billing guidelines to providers on the same day.
But Bristol said she was turned away by CVS in the Bronx after three days, citing insurance issues. She tried to make another appointment for this upcoming Monday, but it was canceled again. She said she contacted MetroPlusHealth, an insurance company run by NYC Health + Hospitals. She finds them “helpful and responsive,” but the problem remains unresolved.
“We are looking into this matter and will clarify our members’ concerns about possible vaccine refusals as soon as possible,” Metroplus spokeswoman Michelle Dominguez said Wednesday.
Meanwhile, CVS is blaming insurance companies.
“Some payers are still updating their systems and may not yet be set up to cover updated COVID-19 vaccines,” spokesperson Matt Blanchett said in a statement. said. “If this happens, our pharmacy team will help patients schedule a later appointment.”
Blanchett added that all CVS locations participate in the Bridge Access program. “If a patient is determined to be uninsured, they are eligible to receive the latest coronavirus vaccine at no cost through CDC’s Bridge Access Program,” he said.
How to find a vaccine – how to avoid appointment cancellations
City Health Department spokesman Patrick Gallahue said clinics run by the city and nonprofits have begun increasing access and more people will be vaccinated in the coming days. Ta. Vaccine appointments will be available at facilities operated by NYC Health + Hospitals starting Oct. 2, spokesperson Christopher Miller said, adding that patients can start making appointments now.
Vito Colombo, owner of Colombo Pharmacy in Queens, said independent pharmacies also have to wait for prescriptions. He pre-ordered a vaccine from Moderna about two weeks ago, but said his order is still pending. But she said she frequently receives calls from customers asking about the vaccine and when it will be available. He advises them to keep checking.
Where vaccines are being distributed vaccine.gov And that New York City Vaccine Finder A site that allows users to search by postal code. However, not all providers listed on these sites actually have doses in stock, and some vaccine providers may not yet be listed.City Health Bureau tweeted This week, New Yorkers are urged to call their pharmacy or doctor ahead of time to find out if a vaccine is available, instead of relying on search engines.
Gothamist has heard from about half a dozen New Yorkers in recent days who have had one or more appointments canceled by CVS or Walgreens due to supply shortages.
Irina Manta said she initially scheduled vaccination appointments for herself and her family at a conveniently located CVS in Manhattan on Monday, but all were canceled because the pharmacy was out of stock. In the end, she and her family ended up buying medicine at pharmacies scattered throughout the city. She needed 4 tries if she was Manta herself. At one Walgreens, she said, she wasn’t told about her shortage until she arrived.
“I’m obviously a highly motivated person when it comes to this,” Manta said. “But I can imagine some people getting really discouraged by the experience and eventually giving up.”
“We are aware of isolated cases at a small number of facilities where appointments have had to be rescheduled due to supply delays,” Walgreens spokeswoman Julia Loring said. Customers were encouraged to call ahead “for the best experience.”
CVS spokeswoman Blanchett said stores are being filled on a rolling basis and “most stores are open for reservations.” However, “Due to delivery delays to some stores, some reservations may be subject to change.”