Southern Scripts is actively monitoring progress towards a COVID-19 vaccine approval. This letter is to inform you of what we currently know about government vaccination plans along with Southern Scripts’ developing standard policy regarding coverage.
While there are many unknowns and unanswered questions at this time, Southern Scripts is working with pharmacy providers to prepare and ensure members who wish to be vaccinated have access to COVID-19 vaccines. Our understanding is that vaccines could be available in as little as a few weeks, with early vaccination efforts focusing on those critical to the response and those at the highest risk for developing severe illness from COVID-19.
With community pharmacies serving as trusted health resources and in close proximity to a large percentage of the population (86% of people live within five miles of a community pharmacy), pharmacies will play a vital role in creating critical access and convenience to support broad vaccination efforts.
COVID-19 vaccines will be procured and distributed by the federal government to COVID-19 vaccination providers to include select pharmacies under the Centers for Disease Control and Prevention’s (CDC) COVID-19 Vaccination Program. Government-purchased doses of vaccines are at no cost. However, providers will be seeking reimbursement for costs associated with administering the vaccine. The anticipated vaccine administration cost per dose is approximately $22; most vaccines will require two doses.
Due to the bipartisan Coronavirus Aid, Relief, and Economic Security (CARES) Act passed by Congress in March, employer-sponsored health plans subject to the ACA’s preventive services standards are required to cover a coronavirus vaccine without cost-sharing 15 days after it is recommended by ACIP.
Based on these requirements and strong recommendations for all health plans to follow the same, Southern Scripts’ standard policy for all clients will be to extend coverage with zero-member cost share for COVID-19 associated administration costs, and if applicable in the future, vaccine costs. If eventually vaccine doses are not purchased by the government, Southern Scripts intends to reimburse the COVID-19 vaccine doses in accordance with its vaccine network agreement with pharmacies similar to influenza and pneumococcal vaccines. Southern Scripts will continue to develop this standard policy as information and best practices further evolve.
While we believe our approach to issue a standardized policy around coverage to be a rational approach intended to aid in vaccination efforts and support COVID recovery, we appreciate that a health plan may have personal and/or business reasons to direct Southern Scripts to handle COVID-19 coverage in an alternative manner. Should you wish to opt-out of this standard policy, please use the link below, entitled “COVID-19 Vaccine Coverage Withdrawal Form“.
And as always, we greatly appreciate the trust and confidence you place in us every day to serve both you and your members. Please contact your dedicated account management team with any further questions or concerns.