Susan Leslie was elated to get the COVID vaccine weeks before she expected. She got her first dose in mid-January through a major hospital system in Central Texas. But that excitement turned to disappointment when she was asked to pay a $51 charge for the shot administration.
“I really got angry, and I think that’s why I just didn’t pay it and say I can scrap somewhere and make it up,” said Leslie, who said she worked for the United States Treasury for 30 years.
She said her experience in government lent her the skill set to investigate if it was even legal for her to be charged for the bill. After a few days of phone calls to Medicare and the hospital system, Leslie said she was refunded the money.
“I would not have paid it (in the first place) except the day after the vaccine, I went to get a cardio procedure and was told I had a balance in the system,” said Leslie, who said she was asked to pay the $51 charge to be allowed access to her appointment.
According to Caitlin Donovan with the National Patient Advocate Foundation, the law is very clear that no one on Medicare, Medicaid, or Affordable Care Act backed insurance should experience any out of pocket charge associated with the COVID-19 vaccine.
“If you get any bills related to the COVID vaccine, you should call your provider and let them know that you received a bill in error because you did,” said Donovan.
But Jon Hess, a consumer healthcare advocate with Athos Health, said it might not be that simple.
“The vaccine itself is free. But where it gets tricky is the administration cost,” said Hess. While the federal law precludes any out of pocket costs to Medicare, Medicaid, Tricare, or ACA backed commercial insurance customers, it does not apply to people who are uninsured or on a non-ACA plan.
If you fall into one of those gaps, you may end up seeing a bill for administrative costs.
But Hess agrees with Donovan that you should not pay it because federal funds are available to providers to get those administrative costs reimbursed.
“Absolutely, call your provider and remind them of that,” he said.