Patty’s Takes: If you want a COVID-19 vaccine, your health plan must cover it

If you want or need a vaccine, including a COVID-19 vaccine, your health plan must cover it, regardless of actions taken at the federal level. This is true more than 1 million people in Washington state enrolled in health plans that my office regulates.

Our office reviews all individual and small employer health plans each year, looking at any benefit changes and, when justified, rate changes. These plans must cover preventive services, including coverage for vaccines that were in force and approved when the plans were filed in May 2024.

This is also true for next year’s plans. They were filed in May 2025 so the benefits that start on Jan. 1, 2026, will be in effect for the rest of the year.

Large employers’ (51 or more employees) health plans renew at different times of the year, so if you have questions about what’s still covered, I encourage you to contact your employer’s human resources office.

We’ve worked hard to preserve many of the benefits provided by the Affordable Care Act in state law and that includes preventive services like vaccinations.

How about COVID-19?

Coverage for vaccines includes the COVID-19 vaccines for anyone who wants one. The Department of Health, which oversees the licensing of health care providers, issued an order this week allowing qualified providers, including pharmacists, to vaccinate children aged six months and older, adults, and pregnant individuals.

Last week, Washington state joined California, Oregon and now, Hawaii to launch a West Coast Health Alliance to pursue our own preventive care standards that align with national organizations such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. This is an important step towards ensuring that the protections we depend on will continue and that decisions will be based on the best science and not political whims or misinformation.

How to get free or low-cost vaccines

Washingtonians under the age of 19 can receive free COVID-19 vaccines through the Childhood Vaccine Program via participating providers.

If you are an uninsured (or under insured) adult, you can receive low-cost vaccines through the Washington State Adult Vaccine Program via participating providers.