The bewildering ordeal of getting billed for a coronavirus vaccine
Raising three kids, Heather Christena Schmidt has learned a lot about emergency rooms. "Kids are always, you know, getting into stuff," she says. So when the first puzzling bill arrived, she knew it wouldn't be the last.
Still, Schmidt, a 39-year-old stay-at-home parent and blogger, felt especially angry over this one.
Schmidt's 13-year-old daughter, Ava, got her second dose of the Moderna coronavirus vaccine on June 22. After her first dose, administered in May at a CVS, Ava fainted. The reason remains elusive. So her primary care doctor recommended she get the second dose at an emergency room, where she could be treated immediately if anything went wrong.
Nothing did; Ava was in and out of the hospital near the Schmidts' home in Camarillo, Calif., in less than a half-hour. But Schmidt has received three separate bills for her daughter's shot that day - one from the hospital system, one from insurance and one from the doctor who administered the shot - totaling $262.50.
We were told from the beginning that they would be free, these vaccines. The official webpage for the government's vaccine rollout reads, in large bold print, "COVID-19 vaccines are free to all people living in the United States, regardless of their immigration or health insurance status," paid for via federal funding and partnerships with insurance companies. President Donald Trump said they were free. President Joe Biden said they were free. For most Americans, it's been uncomplicated: They're free.
Nevertheless, a tiny subset of Americans have gotten billed anyway, some in small, annoying-on-principle amounts, others in more alarming denominations. Some have seen their bills quickly disappear after a phone call, waved away as errors. Others - Schmidt, for example - have found themselves in long, unpleasant games of telephone, stuck with the difficult choice between paying for a shot or jeopardizing their credit scores, putting our bewildering system on full, vexing display.
I should admit here that I was charged for my coronavirus vaccine - $567, in fact. And initially, I wondered whether that was my karmic penalty for getting it early.
On March 6, I had already spent weeks obsessively checking for updates on when I, an otherwise healthy 31-year-old with asthma, would qualify in my home state of New Jersey. So when a friend texted me that he'd heard the Jersey City Medical Center nearby was handing out doses of the Johnson & Johnson vaccine that had been approved just days before, I dropped everything and leaped into my car. When I arrived, I told the front desk why I was there. A security officer pointed me toward the emergency department.
Claire Fallon, a freelance writer based in Jersey City, found out about the shots from the same mutual friend. Fallon, 33, sat just a few feet away from me in the waiting room; she told me later that at the time, she had recently joined her husband's insurance but didn't have a card yet. She and the nurse on duty decided she would simply be categorized as an "uninsured."
The first bill - from the hospital network, RWJBarnabas Health - showed up about two months later. Like mine, Fallon's was for $567, but hers came with an "uninsured discount adjustment" down to $73.71. Fallon later received an additional bill from the Jersey City Medical Center for $251.58.
When Fallon called the number on her second bill, the agent said "she would put a hold on it until we figured out what was going on," Fallon remembers. "That was the last I heard of it." Fallon still worries, months later, about that outstanding bill.
I'm not proud of it: I ignored my bill. Right up until I got a phone call reminding me to pay it in June while I was vacationing. Flustered, I told the agent on the phone that I didn't think I needed to pay $567 for a free vaccine. In September, I got a new bill from RWJBarnabas: A "covid-19 adjustment" brought the total down to $225.39. On Oct. 11, I called them to ask why I was still being charged; the representative told me he would send my bill out for review, and acknowledged that I "shouldn't have to pay anything." As of Nov. 3, it was still under review.
RWJBarnabas said in a statement to The Washington Post that it "does not charge patients for the vaccine. Vaccine administration is billed to insurers. However, patients who receive medical screenings in our emergency department are billed for the emergency room visit, as is customary." (Although that's where the vaccinations took place, I received no other medical treatment.)
Laurie Todd, based in Kirkland, Wash., does business as "the Insurance Warrior," writing appeals for clients with far weightier problems, such as when their lifesaving treatments are denied insurance coverage or deemed out-of-network. As a result, she hasn't dealt with any bills for coronavirus vaccines, she notes, but if she did, she would skip phoning a billing office and go straight to an executive at whatever clinic, pharmacy or insurance company sent the bill - via email.
"Attach a copy of the bill. Point out to them that ... vaccinations are free to all citizens," she told The Post in an email.
The U.S. Department of Health and Human Services has its own resources for Americans who are caught off guard. An open letter on the website for its Office of the Inspector General tells vaccine providers that coronavirus shots are to be administered at "no out-of-pocket cost to the recipient" and that providers "may not charge an office visit or other fee if COVID-19 vaccination is the sole medical service provided."
"If any patient is billed for COVID-19 vaccines, they should contact the sender and ask them to send that bill either to the federal government if they are uninsured or underinsured, or to their insurance company if they are insured," a representative for HHS says in a statement. "If this fails, patients should report this issue by filing a complaint with HHS OIG."
Danny Tenenbaum, who represents the 95th district in the Montana House of Representatives, was billed $56.96 in August for the Moderna shots he received at a county-run vaccination site. Initially, the billing company waved him off: This is what the health care provider told us to do. So Tenenbaum reminded the representative of the HHS guidance - and issued a light but unmistakable warning.
" 'You should probably talk to your manager and people higher up within your billing company, because what you're doing violates federal regulations regarding the covid vaccine,' " Tenenbaum remembers saying.
The next day, an executive from the billing company called and apologized, Tenenbaum says, and told him to tear up the bill.
In the end, the only price Tenenbaum paid for his vaccine was two hours of his time waiting around on the phone. Still, those were two hours of his evening that he wasn't helping his wife parent their two small children, he says. "And you end up wondering who else is getting these bills," Tenenbaum adds. "They're going to pay it even though they really shouldn't, and they shouldn't have been billed in the first place."
Schmidt has negotiated away the first two of her bills, and plans to fight the third one, though it's for just $22.53. But she worries about the members of her community who might not have the time or know-how to haggle over the bill, or the money to pay it.
And Schmidt has concerns about the damage vaccine bills could do to the effort to get Americans vaccinated.
"I don't think that everybody that's not vaccinated is not vaccinated just because they're opposed to it," Schmidt says. "I think there are people that probably are afraid to get a bill. They know someone that got one."
Related Content
