Insurers to Cover Updated COVID-19 Shots as Fall Vaccination Season Begins
Health insurers say they will cover the FDA-approved updated COVID-19 vaccines for the 2026-27 season, while uninsured individuals can access free doses through public programs.
The Food and Drug Administration approved updated COVID-19 vaccines from Moderna, Pfizer and Sanofi on Thursday, and they are expected to be distributed nationwide this fall. Health-insurance trade group AHIP said its member plans will cover the shots for the 2026-27 season, consistent with a commitment made last year to fund all vaccines recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) without cost-sharing through the end of 2027. The Affordable Care Act requires such coverage for ACIP-endorsed vaccines.
"Health insurance plans are expected to cover updated COVID-19 vaccines this season," AHIP said in a statement to ABC News.
The agency noted that coverage decisions also consider scientific evidence and applicable federal and state laws. For people without insurance, the Department of Health and Human Services indicated that state or local health departments may provide free COVID-19 vaccines, and the CDC’s Vaccines for Children program offers no-cost vaccines to eligible children, including those uninsured or on Medicaid.
The updated vaccines are authorized for specific age groups and risk categories. Moderna’s Spikevax is approved for ages 6 months to 64 with high-risk conditions, while its newer mNEXSPIKE targets ages 12 to 64 with similar risk factors. Pfizer’s Comirnaty is cleared for ages 5 to 64, and Sanofi’s protein-based Nuvaxovid for ages 12 to 64, all for individuals with underlying conditions that increase severe COVID-19 risk. The American Academy of Family Physicians recommends vaccination for all adults 19 and older, emphasizing those 65 and older, high-risk groups and the unvaccinated, and advises a risk-based approach for children and teens.
Public-health officials also urged timely flu and RSV vaccinations. Dr. Ronald Nahas, president of the Infectious Diseases Society of America, said early administration of all three seasonal vaccines remains the most effective way to prevent hospitalizations and serious illness.
The AAFP advises an annual flu shot for everyone aged 6 months and older, with high-dose or adjuvanted options preferred for adults 65 and older. The CDC recommends a one-time RSV vaccine for adults 75 and older and for adults 50-74 with elevated risk, as well as specific antibody products for infants and young children. Pregnant people are advised to receive Pfizer’s RSV vaccine between weeks 32 and 36 of pregnancy.