SUBJECT: People Enrolled in Medicaid and CHIP Who are Eligible for COVID-19 Vaccine Boosters will Receive it at No Cost

Medicaid.gov sent this bulletin at 09/27/2021 11:21 AM EDT
 

View in browser | Distributed by Center for Medicaid and CHIP Services (CMCS)
Medicaid.gov

On September 22, the Food and Drug Administration (FDA) amended of the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine to allow for use of a single booster dose to be administered at least six months after completion of the primary series for:

  • individuals 65 years of age and older;
  • individuals 18 through 64 years of age at high risk of severe COVID-19; and 
  • individuals 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19.

More information on the FDA’s authorization can be found here.

Additionally, on September 24, the Centers for Disease Control and Prevention (CDC) recommended:

  • people 65 years and older and residents in long-term care settings should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
  • people aged 50–64 years with underlying medical conditionsshould receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
  • people aged 18–49 years with underlying medical conditionsmay receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and
  • people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

More information on the CDC’s recommendations can be found here.

As a reminder, in accordance with the American Rescue Plan Act of 2021 (ARP), nearly all Medicaid and CHIP beneficiaries must receive coverage of COVID-19 vaccines and their administration, including these boosters, without cost-sharing. People can visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.

CMS will release an updated Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration, and Cost Sharing under Medicaid, the Children’s Health Insurance Program, and Basic Health Program toolkit in the near future to reflect this and other relevant updates.