A VERIFY viewer shared a copy of his Explanation of Benefits after getting the COVID-19 vaccine with a question about the shot’s provider.
INDIANAPOLIS — More than 2.5 million people have received the COVID-19 vaccine in Indiana, and many of them may soon receive paperwork from their insurance company showing a charge for that shot. That should be for the administrative fee providers can collect to help cover their costs.
For people who received a shot in Indiana, the provider listed on that Explanation of Benefits will likely be Dr. Kristina Box, who is the state health commissioner.
That provider line on his insurance statement prompted a viewer to ask about the payment and where it goes.
Lou asked, “Did these funds go to [Dr. Box] personally? Or is this an abbreviation for a payment to the state?”
State Health Commissioner Dr. Kristina Box does not receive any payment for COVID-19 vaccinations given in Indiana, but she is listed as the provider on most all of the vaccine procedures.
The state does collect the administrative fee that is then distributed to the various organizations that administered the shots.
WHAT WE FOUND
Lou received an Explanation of Benefits from his insurance company that showed the COVID-19 vaccine he received in February. It shows the insurance company covering the $16.94 cost, but one line in particular caught Lou’s attention. It reads, “Services provided by BOX KRISTINA.”
Paperwork for vaccines given in Indiana is likely to list Box as the provider. In fact, people who signed up for the vaccine through the state website may have noticed a dropdown menu at the top of the page to select a provider. Box was the only option.
A spokesperson for the Indiana State Department of Health confirmed in an email to VERIFY, “Dr. Box does not receive any revenue from the vaccine administration fees.”
During the current health emergency, the vaccine itself is free to everyone.
However, groups that administer the doses are permitted to request an administrative fee from insurance companies to cover the cost of providing the shots.
RELATED: VERIFY: If the COVID-19 vaccine is free, why am I being asked to show my health insurance card?
The state health department said it collects that insurance reimbursement “to grant back to providers administering vaccine to help offset some of their costs. For vaccinations conducted by (the Indiana State Department of Health) directly, the fees collected are used to offset expenses related to vaccinations.”
The administrative fee for Lou’s first dose was $16.94, and that is the same amount many other people may see as well because that’s the reimbursement amount the Centers for Medicare & Medicaid Services (CMS) approved for first doses given before March 15.
Indiana’s health department told 13News many other insurance carriers are using those rates as well.
RELATED: Are businesses violating federal law by asking if you’ve gotten a COVID-19 vaccine?
Earlier this year, CMS increased the amount that vaccine administrators are allowed to bill to about $40 per dose. CMS said that increase “reflects updated information about the costs involved in administering the COVID-19 vaccine for different types of providers and suppliers, and the additional resources necessary to ensure the vaccine is administered safely and appropriately.” You can find the full list of vaccine payment allowances online.
So, many people may see administrative costs between $16 and $40 for each dose of the vaccine.
However, keep an eye on the line that shows what the insured person owes the provider. It should be zero for the vaccine during the public health emergency.