Medicare Covers At-Home COVID-19 Vaccines

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  • If you’re a Medicare beneficiary who is homebound, you may be eligible for an at-home COVID-19 vaccine as part of Medicare’s effort to remove vaccination barriers and improve access.

Have you wanted to get the COVID-19 vaccine, but you’re unable to travel to a vaccination site? You’re not alone. Approximately 1.6 million adults ages 65 and older may have trouble accessing the COVID-19 vaccine because they are homebound. Fifty-one percent of these older adults face at least one additional barrier, such as living alone or lacking technology.

The good news is that Medicare now covers an at-home COVID-19 vaccine. That means you may be able to receive the vaccine from the comfort of your home without having to go to your doctor’s office or another vaccination site where you run the risk of contracting the virus. Here’s what you need to know.

Can Anyone Receive an At-Home COVID-19 Vaccine?

To receive a COVID-19 vaccine at your home, you must be homebound as defined by Medicare. This means you need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave your home. It could also mean that your medical provider believes that your health or illness could get worse if you leave your home.

How Much Will the COVID-19 Vaccine Cost Me?

Those with Original Medicare and Medicare Advantage (also called Medicare Part C) plans do not pay anything for the vaccine. There is no copayment, coinsurance or deductible. This is true regardless of whether you receive the vaccine in your home or elsewhere.

However, your home vaccination provider will be paid more for doing it in your home. That’s because Medicare recently incentivized providers to give at-home vaccines by paying an additional $35 per dose, increasing the total payment for at-home vaccination from approximately $40 to approximately $75 per dose. If you receive a two-dose vaccine, the provider will receive approximately $150.

Why Are Healthcare Professionals Paid More for Administering an At-Home COVID-19 Vaccine?

There are several reasons.

  • First, providers who travel to access-challenged and hard-to-reach individuals must ensure that they store the vaccine at proper temperatures. The added payment can help them identify ways to do that.

  • In addition, the higher payment accounts for the clinical time necessary to monitor you after the vaccine is administered as well as any costs associated with administering it safely in your home.

What Can I Expect When Receiving an At-Home COVID-19 Vaccine?

To minimize wasting vaccine doses, your home vaccination provider who administers your vaccine will likely contact you in advance to ask you what vaccine you prefer to receive and whether any other caregivers in the home will also receive a vaccine.

On the day the visit, your home vaccination provider will safely transport the vaccine to your home. Before administering the vaccine, the provider will screen you for contraindications and precautions.

Are Home Vaccination Providers Trained to Work With Older Adults?

Yes. Your provider will be trained in accessibility-specific issues. For example, they will know how to work with people who are blind or who have limited vision as well as those who are deaf or hard of hearing. They will provide you with information about the vaccine and answer any questions you may have. Information will be available in a variety of accessible formats (e.g., American Sign Language, multiple languages, braille, large font, low literacy, materials with pictures or visual cues).

What if I Have a Reaction After Receiving an At-Home COVID-19 Vaccine?

Your home vaccination provider is prepared. For example, if you should experience anaphylaxis, your provider will be able to recognize and treat it immediately. They will have at least three doses of epinephrine on hand when administering the vaccine.

How Long Will I Be Observed After Receiving an At-Home COVID-19 Vaccine?

It depends. If you have a history of an immediate allergic reaction to a vaccine or injectable therapy, your home vaccination provider will observe you for 30 minutes. Otherwise, they’ll observe you for 15 minutes.

How Can I Make an Appointment to Get an At-Home COVID-19 Vaccine?

Each city and/or state may have different requirements. Your best bet is to contact your local Agency on Aging and ask them about your state’s homebound COVID-19 vaccination program. They should be able to help you determine eligibility for at-home vaccination as well as next steps.

About the Author

Lisa Eramo is an independent health care writer whose work appears in the Journal of the American Health Information Management Association, Healthcare Financial Management Association, For The Record Magazine, Medical Economics, Medscape and more.

Lisa studied creative writing at Hamilton College and obtained a master’s degree in journalism from Northeastern University. She is a member of the American Health Information Management Association, American Academy of Professional Coders, Society of Professional Journalists, Association of Health Care Journalists and the American Society of Journalists and Authors.

Lisa currently resides in Cranston, Rhode Island with her wife and two-year-old twin boys.

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