A major health insurance group reaffirmed that its member plans will uphold current vaccine coverage despite any changes that an influential advisory panel could make to federal recommendations.
The pledge to continued vaccine coverage comes ahead of a scheduled meeting Thursday of a federal advisory committee with a slate of new members handpicked by Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.
Health plans are required to cover vaccines, without cost-sharing, that are recommended by the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP), which is in line with federal requirements as part of the Affordable Care Act and the Inflation Reduction Act.
“Health plans are committed to maintaining and ensuring affordable access to vaccines. Health plan coverage decisions for immunizations are grounded in each plan’s ongoing, rigorous review of scientific and clinical evidence, and continual evaluation of multiple sources of data," AHIP said in a statement issued Tuesday.
AHIP said its plans will continue to cover all vaccines recommended by the ACIP as of Sept. 1, 2025, including updated formulations of the COVID-19 and influenza vaccines, with no cost-sharing for patients through the end of 2026.
Members of AHIP include major insurance companies Aetna, Centene, Cigna, Elevance Health and Humana as well as major Blues plans and other health insurance plans like Oscar Health.
“While health plans continue to operate in an environment shaped by federal and state laws, as well as program and customer requirements, the evidence-based approach to coverage of immunizations will remain consistent," AHIP said in its statement.
The Blue Cross Blue Shield Association, which is made up of 33 independent BCBS companies providing coverage to more than 115 million people, also said it would uphold current vaccine coverage standards.
“BCBS companies will continue covering all immunizations that were recommended by the Advisory Committee on Immunization Practices (ACIP) on January 1, 2025, with no cost-sharing through 2026, while operating within federal and state laws and meeting program and customer requirements," a BCBSA spokesperson said.
“Blue Cross and Blue Shield (BCBS) companies are committed to ensuring access to vaccines that protect individuals and communities from serious illness. The decision to receive a vaccine is made between patients and their health care providers and we remain committed to maintaining rigorous, evidence-based processes to evaluate coverage policies," the spokesperson said.
UnitedHealthcare, the largest insurer in the U.S., also reiterated its commitment to "enabling access to safe, effective and affordable care, including coverage for vaccinations."
"Vaccines are an important and effective way to protect the health of individuals, families and communities, and members should talk with their health care providers to determine if a COVID-19 vaccine is clinically appropriate. For our standard commercial plans, we will continue to cover claims for COVID-19 vaccines with no cost share," the company said.
UnitedHealthcare recommends that members in self-insured employer sponsored plans always confirm their specific plan benefits. "Coverage of COVID-19 vaccines with no cost share is also available to our Medicare members in accordance with CMS requirements and to our Medicaid members in accordance with any applicable state requirements," the insurance giant said.
The public commitments come as shifting federal COVID-19 vaccine criteria are making seasonal vaccinations a more complicated process, both for patients and providers.
The Food and Drug Administration (FDA) recently approved the next round of COVID-19 vaccines but only for a smaller, high-risk group. The administration is restricting their use for people ages 65 and older as well as adults and children over 6 months who have risk factors for developing severe COVID-19.
Pharmacies and providers are now navigating a regulatory patchwork with slightly different vaccine policies across 49 states and Washington, D.C., as the industry awaits recommendations from the CDC's revamped ACIP.
In many states, pharmacists cannot administer vaccines that are not on the ACIP's recommended list, even if a vaccine has FDA authorization.
In late August, RFK Jr. laid out the administration's regulatory approach to COVID-19 vaccines through a post on X. He said the framework delivers "science, safety and common sense" and will enable continued access for vulnerable people who want vaccines.
The overhauled ACIP is scheduled to meet Thursday and Friday, the first meeting with 12 new members all selected by RFK Jr. The group will discuss recommendations around vaccines for COVID-19, hepatitis B and measles, mumps and rubella (MMR). RFK Jr. overhauled the CDC's vaccine advisory panel over the summer, replacing 17 of its prior members with seven of his own selections and then added to the lineup with five new appointees on Monday.
Former CDC Director Susan Monarez, Ph.D., told a Senate hearing Wednesday that RFK Jr. told her there was “no science or evidence” in support of the current childhood vaccine schedule and that he planned to change it in September.
Monarez testified in front of a Senate health committee about the event leading up to her firing in August.
The ACIP panel is scheduled to spend much of Thursday discussing safety data and recommendations for hepatitis B vaccinations at birth before voting on that issue, plus guidance around MMR vaccines, according to a draft meeting agenda (PDF) on the CDC’s website, Fierce Pharma reported.
Friday, Sept. 19, the panel will focus solely on COVID-19 vaccines before voting on recommendations for the shots, homing in on updated safety and efficacy data as well as current epidemiology trends.
The CDC advisory panel is expected to vote to recommend delaying until age 4 the hepatitis B vaccine that’s currently given to newborns, KFF Health News reported, citing two former senior CDC officials.