The California Department of Managed Health Care (DMHC) issued guidance reminding health plans that all approved COVID-19 vaccines must be provided without any cost-sharing for health plan enrollees who may receive the vaccine from an in-network or out-of-network provider during the federally declared COVID-19 public health emergency.
“As we begin to enter this new phase of the pandemic with vaccines becoming available, the DMHC is reminding health plans they must cover the cost of COVID-19 vaccines,” said DMHC Director Mary Watanabe. “It is critical that all Californians have access to a safe COVID-19 vaccine to help protect their health. Financial challenges should not and will not get in the way of getting protection from COVID-19.”
The DMHC has issued an All Plan Letter asking full-service health plans to cover qualifying vaccines that are meant to protect against COVID-19. In compliance with the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, health plans must cover the costs of administering vaccines without any enrollee cost-sharing which would include co-pays, co-insurance or deductibles.
If a health plan enrollee accidentally receives a bill related to the coverage or administration of a qualifying COVID-19 vaccine, they will have to file a grievance with their health plan and include a copy of the bill in the same. Their health plan will review the grievance of the enrollee and reimburse the bill. However,if the enrollee does not agree with their health plan’s response or if the plan takes more than 30 days to solve the problem, a complaint needs be filed with the DMHC Help Center at www.HealthHelp.ca.gov or 1-888-466-2219.
The California Department of Public Health has issued guidelines for COVID-19 vaccination which describe how California will operate its COVID-19 vaccination program. According to the DMCH guidelines, the state will be following the three-phased approach to vaccination as developed by the Centers for Disease Control and Prevention (CDC).
In Phase 1, characterized by limited supply of vaccine, California will focus its efforts on vaccinating its critical populations, which includes health care personnel, people at greater risk for severe illness or death, and other essential workers. In Phases 2 to 3, the increased supply of vaccines will be made available to majority of the population.
As you wait for the COVID-19 vaccine to be available in California, you should take proactive measures to protect your health with the right health insurance and life insurance. When looking for the right coverage, don’t hesitate to contact the experts at Donald Weiss Insurance Services. Our dedicated team is ready to assist you with all your insurance needs.
