COVID-19 treatment
Medicaid: COVID-19 treatments, including the oral antiviral Paxlovid, will be covered with no cost sharing through September 2024. After that, coverage and cost will likely vary by state.
Medicare: There should no change in Medicare coverage of treatments once the PHE ends. In cases where cost sharing and deductibles apply now, they will continue to apply.
The good news is that the antiviral treatment Paxlovid will most likely continue to be free for some time after the public health emergency expires. “As long as there’s federal supply that the government purchased and distributed, that will be free for anybody,” says Juliette Cubanski, deputy director of the Program on Medicare Policy at KFF, a health policy nonprofit.
Private insurers: When current inventories of Paxlovid are exhausted after the public health emergency ends, private insurers may ask you to pay a part of the cost, as they do with many pharmaceuticals. Pfizer likely will hike the price from what the government has been paying, already $530 per course of treatment.
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