There is a third vaccine by Astrazeneca/Oxfordcurrently under review by the regulatory agencies. There are high hopes for this vaccine due to its lower cost and easier storage requirements.

For the latest on COVID-19’s impact on benefits and employment, check out our FAQs here.

Employer & Employee Cost

The ingredient cost of the vaccine will initially be covered by the federal government. The vaccine administration costs will be the responsibility of the employer’s health plan. The cost to administer the vaccine will be approximately $45 per patient. This cost may be broken up, depending on whether the patient receives a 2-dose or 1-dose regiment. The number of doses is dependent on the specific vaccine per the FDA emergency approval.

Pharmacy or Medical Benefit?

Our general recommendation for most employers is to include coverage of COVID vaccines under the pharmacy benefit and to do so at $0 cost to plan participants. However, COVID vaccine claims may also flow through the medical benefit. These costs should be similar to the CMS fee schedule. It is best to consult with your consultant to determine the best plan of action for your business.

More information can be found in the CDC’s “COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations.”