This article was adapted from City Cast Pittsburgh host Megan Harris’ article.
Two new COVID vaccines, developed by Pfizer-BioNTech and Moderna, received the green light from the FDA last month and were shipped to pharmacies across the country — but many Philadelphians initially reported trouble securing their booster. We break down what’s different this time around, and share tips for getting the jab.
Why Is It So Hard To Get?
Booster rollout has been troublesome nationwide. In the past, the federal government bought vaccines and distributed them for free; this year, pharmacies must buy the vaccine directly from suppliers. As one health and policy expert told NPR, this is the first year the vaccine is being commercialized.
Another problem? Lack of supply. Pharmacies are scheduling appointments, but then don’t have the vaccine in stock. This is the first time insurers were supposed to cover the cost of vaccines as preventative medicine (instead of the government), but many haven’t updated their billing codes.
This last part is especially frustrating because we knew this was coming — the administrator of the Centers for Medicare and Medicaid Services sent a letter to insurers back in July urging them to update their systems by mid- to late-September.
What Can You Do?
- Confirm Your Coverage: Call your insurance company and confirm both that they’re going to cover the booster, and that they’ll honor that payment wherever you’ve made your appointment. You can’t go anywhere. The pharmacy or clinic has to be in-network unless there’s nowhere to go in-network with the vaccine in stock. If that’s the case, insurers are supposed to cover it even if it's out-of-network — but you may have to fight.
- Confirm Again: Call the pharmacy or clinic on the day of your appointment to confirm that they have the vaccine in stock. Many try to send automated cancellation messages if they run out, but those systems aren’t foolproof.
- Be Patient: Experts say pharmacies should be getting more vaccines in stock and insurance companies are supposed to be updating their billing codes.
- Keep Testing: You can request up to four free COVID tests for your household at covid.gov/tests.
