Health insurance

What you need to know about health insurance and vaccination status


Your immunization status will not affect your ability to obtain health insurance through work or through state-sponsored exchanges. Those who still have not received the COVID-19 vaccine should thank the Affordable Care Act for this protection, says Emily Langdon, an employee benefits lawyer at law firm Fraser Stryker. “So you can’t say ‘no, because you’re not vaccinated we won’t let you qualify for coverage,’” she said. “Because they have to provide cover.” Under the ACA, a business with 50 or more employees must provide health insurance for its workers and their dependents. Eligibility for health insurance if they are not vaccinated. For businesses, this is the basics. “We have intensive care stays, and things like that.” From June to August 2021, the Kaiser Family Foundation tracked hospital costs for unvaccinated patients at $ 5.7 billion. Study after study from medical researchers show that vaccines from Pfizer, Moderna and Johnson and Johnson can provide up to 85% protection against hospitalization in those who contract COVID-19. But just because a workplace or health insurance can’t deny you coverage based on immunization status, that doesn’t mean unvaccinated workers won’t pay more. About half of Langdon’s customers are exploring or planning COVID-19 wellness programs. are going to implement this program and if you are not vaccinated by the end of the year and provide the proof, you are going to have higher health care costs, ”she said. Many companies have already included influenza vaccination or smoking cessation programs in their programs. wellness plans, with incentives for healthy behavior. Delta Airlines was the first major airline to announce surcharges for those who refused vaccinations during the pandemic. Unvaccinated airline employees face monthly surcharges of $ 200 on their health insurance premiums. As millions of Americans enter enrollment season to purchase their health insurance benefits for the first time during the pandemic with widespread access to a free and safe vaccine, Langdon says they shouldn’t be surprised to see some changes. , ‘OK, you get a supplement if you’re not vaccinated or you get an incentive if you are,’ it’s really the same thing, “she said.” Whether it’s carrot or the stick. ”Under federal law, these surcharges or incentives based on wellness programs can be up to 30% of the premium price. The issue of immunization status and health insurance concerns only workplaces that do not yet have COVID-19 for their workers.Vaccination as a condition of employment is a separate issue, and lawyers explained that case law supports these mandates.

Your immunization status will not affect your ability to obtain health insurance through work or through state-sponsored exchanges.

Those who still have not received the COVID-19 vaccine should thank the Affordable Care Act for this protection, says Emily Langdon, a benefits lawyer at law firm Fraser Stryker.

“So you can’t say ‘no, because you’re not vaccinated, we won’t let you be eligible for coverage,'” she said. “Because they have to provide cover.”

Under the ACA, a business with 50 or more employees must provide health insurance for its workers and their dependents.

But spouses are a different story, and Langdon has clients who drop employee spouses from Medicare eligibility if they aren’t vaccinated.

For businesses, this is the bottom line.

“Well, people who aren’t vaccinated are much more likely to contract COVID-19, which could mean significantly higher health costs,” Langdon said. “We have intensive care stays, and things like that.”

From June to August 2021, the Kaiser Family Foundation estimated hospital costs for unvaccinated patients at $ 5.7 billion. Study after study, medical researchers show that vaccines from Pfizer, Moderna and Johnson and Johnson can provide up to 85% protection against hospitalization in those who contract COVID-19.

But just because a healthcare professional or health insurance provider can’t deny you coverage based on your immunization status doesn’t mean unvaccinated workers won’t pay more.

About half of Langdon’s customers are exploring or planning COVID-19 wellness programs.

“They are looking and saying this is available so we are going to implement this program and if you are not vaccinated by the end of the year and provide proof you are going to have more health care costs. high, “she said.

Many companies have already included flu vaccination or smoking cessation programs in their wellness plans, with incentives for healthy behavior.

Delta Airlines was the first major airline to announce surcharges for those who refused vaccinations during the pandemic. Unvaccinated airline employees face monthly surcharges of $ 200 on their health insurance premiums.

In the weeks since the tax was implemented, the airline said it had achieved 90% vaccination across its workforce.

As millions of Americans enter enrollment season to purchase their health insurance benefits for the first time during the pandemic with widespread access to a free and safe vaccine, Langdon says they shouldn’t be surprised to see some changes.

“Whether it’s ‘OK you get a supplement if you’re not vaccinated or you get an incentive if you are,’ it’s really the same,” she said. “Whether it’s the carrot or the stick.”

Under federal law, these surcharges or incentives based on wellness programs can be up to 30% of the premium price.

The issue of vaccination status and health insurance only concerns workplaces that have not yet mandated COVID-19 for their workers. Vaccination as a condition of employment is a separate issue, and lawyers explained that case law supports these mandates.