Q: Must employer sponsored health plans cover a vaccine for COVID-19 when it becomes available?
A: Yes. Under the CARES Act, all health plans, whether private, governmental or church plans are required to cover U.S.-government approved measures to prevent COVID-19, including vaccines, without cost sharing. This applies to all types of group health plans as well, including PPO, HMO, high deductible health plans, and even minimum essential coverage plans.
Once a vaccine or other preventive measure is approved by the U.S. Preventive Services Task Force or Advisory Committee on Immunization Practices, plans will need to cover on a first dollar basis starting 15 business days after it is approved. This is significantly faster than the normal timeframe, which is the first plan year that begins at least 12 months after a preventive item or service is approved.
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