DFS To Extend Regulation Requiring Health Insurers to Waive Co-Pays for COVID-19 Vaccine Until April 30
Governor Andrew M. Cuomo today directed the Department of Financial Services to extend the emergency regulation requiring all health insurers to waive co-pays for the COVID-19 vaccine until April 30. The extension of this regulation and guidance will help to ensure there are no barriers to New Yorkers accessing the vaccine as the State continues to implement its vaccine administration plan and get every New Yorker vaccinated.
"We know the vaccine is the weapon that will win the war against COVID and we are doing everything we can to get more shots in arms as quickly as possible and become the first COVID-free state in the nation," Governor Cuomo said. "From the beginning of our vaccination efforts we've prioritized vulnerable communities that have been hit the hardest by COVID, and extending this regulation will further break down barriers to access and help ensure that no New Yorker is denied a vaccine just because they can't afford it."
First issued December 16, 2020, the regulation requires a policy or contract that provides hospital, surgical, or medical care coverage, including a grandfathered health plan, to provide immediate coverage, without cost sharing, of COVID-19 immunizations and the administration thereof at a provider's office, facility, pharmacy, or other setting, including any provider or location authorized by New York State or the federal government to administer or host the administration of the immunization.
The New York State Department of Financial Services also previously issued a circular letter to New York-regulated health insurers directing them to immediately cover, without cost-sharing, approved COVID-19 immunizations and their administration.
Department of Financial Services Superintendent Linda A. Lacewell said, "DFS has been at the forefront of this virus since the first case by providing financial regulatory relief to New Yorkers and businesses across the state. It is now more important than ever to get vaccinated as New York continues to rebuild, which is why DFS is extending the regulation to require New York health insurers to waive co-pays for the COVID-19 vaccine. We believe all New Yorkers should have access to vaccines without the financial burden of co-pays."
Federal rules also require COVID-19 immunizations and their administration to be covered when provided by out-of-network providers for the duration of the public health emergency. Health care providers that participate in the Center for Disease Control (CDC) COVID-19 Vaccination Program must agree to administer a COVID-19 immunization regardless of an individual's ability to pay or health insurance coverage status, and may not seek reimbursement from the immunization recipient.
DFS expects full adherence to state and federal requirements for coverage of any approved COVID-19 immunization and its administration.