The Vaccines Are Supposed to Be Free. Surprise Bills Could Happen Anyway.

When Americans receive a coronavirus vaccine, federal rules say they shouldn’t have to pay anything out of pocket.

Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients.

To consumer advocates, the rules seem nearly ironclad — yet they still fear that surprise vaccine bills will find their way to patients, just as they did with coronavirus testing and treatment earlier this year.

“It is the American health care system, so there are bound to be loopholes we can’t anticipate right now,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University.

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Americans vaccinated this year and next generally will not pay for the vaccine itself, because the federal government has purchased hundreds of millions of doses on patients’ behalf. It has agreed to buy 100 million doses from Pfizer-BioNTech — and is in negotiations for more — and 200 million from Moderna, enough to inoculate 150 million Americans (the vaccines require two shots). It also has orders in to purchase more