Latest Breaking News

BumRushDaShow

(160,061 posts) Sat Sep 6, 2025, 03:13 AM Sep 6

For some, Medicare isn't covering the updated Covid vaccine yet

Source: NBC News

Sept. 5, 2025, 3:56 PM EDT

Some older Americans on Medicare are facing an unexpected problem: The updated Covid shots — approved last month by the Food and Drug Administration for all adults 65 and up — aren’t being covered, forcing them to decide whether to pay out of pocket.

Allison Engel, 74, said she visited her CVS in Pasadena, California, on Tuesday, where she was told the shot would cost $225 out of pocket. “They typed everything in, and handed me a rejection letter,” Engel said. “They told me it wasn’t in the Medicare system yet and I should come back in two weeks.” Engel didn’t want to wait, so she paid out of pocket, and hopes Medicare will reimburse her.

Brant Mittler, 78, of San Antonio, said he and his wife stopped by their CVS pharmacy on Monday where they ran into the same issue. “The pharmacist tells my wife, ‘We’ve had Medicare patients coming in all day, and everybody’s upset because we can’t give it,’” he said. Mittler said they got their Covid shots Thursday after the pharmacist said Medicare had updated the system there.

Their experiences are at odds with remarks from Health Secretary Robert F. Kennedy Jr., who told a Senate committee on Thursday that most Americans are going to be able to get a Covid shot from their pharmacy for free. As HHS secretary, Kennedy oversees Medicare.

Read more: https://www.nbcnews.com/health/health-news/-medicare-isnt-covering-updated-covid-shots-yet-rcna229338

4 replies

= new reply since forum marked as read

Highlight:

For some, Medicare isn't covering the updated Covid vaccine yet (Original Post) BumRushDaShow Sep 6 OP

I wasn't aware snowybirdie Sep 6 #1

The other D.C. medical charlatan - Dr. Oz - who is supposedly in charge of CMS BumRushDaShow Sep 6 #2

ACIP to meet Sept 18-19 Blue Dotty Sep 6 #3

Besides Medicare, does anyone have an additional plan such as Tri-Care for Life for example? ProudMNDemocrat Sep 6 #4

snowybirdie

(6,335 posts)

1. I wasn't aware

Reply to BumRushDaShow (Original post)

Sat Sep 6, 2025, 06:17 AM

Sep 6

this was happening and was waiting for the new shot. Damn why is this not broadcast anywhere?

BumRushDaShow

(160,061 posts)

2. The other D.C. medical charlatan - Dr. Oz - who is supposedly in charge of CMS

Reply to snowybirdie (Reply #1)

Sat Sep 6, 2025, 06:40 AM

Sep 6

is probably off vacationing at one of his 9 mansions. This sounds like a slow (probably intentional) response by some GS-1000 to the IT staff/contractors to update the system to include the vaccines so the pharmacies know who (if anyone) will cover this.

I have to dig through a million Taylor Swift/Travis Kelce links to find stuff that might be impactful to DUers.

Blue Dotty

(158 posts)

3. ACIP to meet Sept 18-19

Reply to BumRushDaShow (Original post)

Sat Sep 6, 2025, 11:18 AM

Sep 6

Last edited Sat Sep 6, 2025, 08:00 PM - Edit history (1)

AARP
Updated Sept 5, 2025

The Advisory Committee on Immunization Practices (ACIP), an influential panel that reviews data and advises the federal government on how vaccines should be used by the general public, is scheduled to meet Sept. 18 and 19 to consider COVID-19 vaccine recommendations for 2025-2026.

This fall, millions of adults could face new challenges in getting a COVID-19 vaccine.
Narrowed vaccine approvals and delayed recommendations are fueling confusion over the fall rollout and sparking questions about who can get the shot, where to find it and who will pay for it.

There have been a few cases where the committee’s recommendations — which shape not only the national immunization schedule but also insurance coverage — have differed from FDA labeling, according to a report from the Congressional Research Service.

It’s unclear what the current ACIP will recommend. The panel was recently overhauled: All 17 members were replaced by 7 new appointees selected by Health and Human Services Secretary Robert F. Kennedy Jr.

https://www.aarp.org/health/conditions-treatments/updated-seasonal-covid-vaccines.html
---------
Politico
August 28, 2025

The next meeting of Health Secretary Robert F. Kennedy Jr.'s newly appointed Centers for Disease Control and Prevention vaccine panel is slated for Sept. 18-19, according to a Thursday notice

https://www.politico.com/news/2025/08/28/hhs-schedules-next-vaccine-panel-meeting-after-cdc-director-ousted-00534042
------
The pharmacy we use is waiting on ACIP meeting before administrating the 2025-2026 Covid 19 vaccine.The local Walgreens stores are booking appointments. I have read here some aare paying out of pocket, hoping to be reimbursed later by Medicare.The surge of positive cases is making me feel uncertain whether to wait until after the panel "decides." Chaos and Cruelty is the point.

ProudMNDemocrat

(20,233 posts)

4. Besides Medicare, does anyone have an additional plan such as Tri-Care for Life for example?

Reply to BumRushDaShow (Original post)

Sat Sep 6, 2025, 11:38 AM

Sep 6

A Medical insurance plan for Active Duty and Retired Military and their spouses.

My late husband served a total of 22 years and Tri-Care for Life was one of his earned benefits I have for the rest of my life. I am grateful for that. For what Medicare does not cover, Tri-Care will. That includes vaccines as well.

Reply to this discussion