The AAFP Government Relations team is kicking off a multi-year effort to explore opportunities to address coverage issues related to the administration and reimbursement of vaccines under Medicare Part B. Currently, Medicare covers all vaccines without cost-sharing but splits coverage between Part B (outpatient care) and Part D (prescription drug coverage).
Currently, patients can receive Part B vaccines (e.g., flu, pneumonia, and COVID-19) at no cost during a physician visit but must visit a pharmacy or pay upfront to receive all other vaccines, such as tetanus and shingles. The split in coverage prevents physicians from providing continuity of care to their patients, creates unnecessary confusion, and reduces the likelihood that patients will receive all ACIP-recommended vaccines.
As we organize our efforts, our team would welcome member stories or examples highlighting the problems with this framework, including some of the struggles they have encountered with patients. These stories would be helpful as the AAFP undertakes an educational effort with policymakers to address this through a policy solution.
Member stories can be shared with Paige Colston at grassroots@aafp.org. If you can provide these by January 31, 2023, we would welcome your stories and examples.