COVID Vaccine Coverage - CA

Vaccine Coverage for COVID-19

The CARES Act requires coverage of the COVID-19 vaccine under ACA preventive coverage. The vaccine must be covered within 15 days of a recommendation by the United States Preventive Services Task Force (USPSTF) or the Advisory Committee on Immunization Practices (ACIP) and adopted by the Director of the Centers for Disease Control and Prevention (CDC). Note that FDA approval does not trigger the 15 day start.

Typically ACA preventive care must only be covered at no cost-share when performed in-network. The CARES Act requires that during the HHS announced public health emergency, coverage must be available at no cost-share both in-network and out-of-network. Grandfathered group health plans are encouraged, but not required, to provide this coverage as well.

While the cost of the vaccine is covered, members may still need to cover the administrative cost and/or office visit expense if applicable. View our Compliance Alert.

As of December, the Centers for Disease Control and Prevention (CDC) adopted a recommendation that health care workers and long-term care residents should be the first to receive the COVID-19 vaccine once it is authorized or approved.

View Articles and Fact Sheets

Vaccine Plans by County

As we begin the daunting task of distributing the COVID-19 vaccine to the millions of Californians eligible through the multi-phase process, each county plays an integral role in organizing and educating the public.  Depending on the population and demographics of each county, the pace of the rollout will vary.  California Counties have established dedicated pages for individuals to learn about vaccine distribution in their area. Use the "All counties" link if your county is not listed below.

Carrier Resources on Vaccine Coverage

Carriers are required to cover the COVID-19 vaccine as outlined in the CARES Act. Below you will find member facing resources you can share with your clients.

View Carrier Resources