DMHC Reminder: Vaccines Will Be No Cost to Enrollees

The California Department of Managed Health Care (DMHC) recently issued guidance reminding all that qualified, approved COVID-19 vaccines must be provided with no cost-sharing forhealth plan enrollees, regardless of whether the enrollee receives the vaccine from an in-network or out-of-network provider. The DMHC issued an All Plan Letter to health plans regulated by the department requiring full-service health plans cover qualifying vaccines to prevent COVID-19. In compliance with the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, health plans must cover the adminis- tration costs without any enrollee cost-sharing, such as co-pays, co-insurance or deductibles. If a health plan enrollee receives a COVID-19 vaccine bill, they should first file a grievance with their health plan. Their health plan will review the grievance and should ensure the enrollee is re- imbursed. If the plan takes more than 30 days to fix the problem, they should file a complaint with the DMHC Help Center at or 1-888-466-2219.