Harrisburg, Pa. — Today, the Pennsylvania Insurance Department (PID) issued a notice that reaffirms PID’s expectations for insurers to cover the COVID-19 vaccine and other important vaccines during the 2025–26 calendar years.
These vaccines should be covered at no cost to consumers, with no extra fees or unnecessary hurdles, and consistent with approved policy language, through at least Dec. 31, 2026. This notice reinforces Governor Josh Shapiro’s Executive Order that safeguards Pennsylvanians’ access to vaccines and protects their freedom to make their own healthcare decisions.
“This is about keeping promises to Pennsylvanians. Vaccines are one of the best ways to prevent serious illness, and we want every Pennsylvanian to have affordable, easy access to protect themselves and their families,” said Pennsylvania Insurance Commissioner Michael Humphreys. “If your health insurance plan says it covers vaccines, that coverage will remain in place at least through 2026. It should be easy for you to get vaccinated.”
What This Means for Pennsylvanians:
No Cost: COVID-19 vaccines and other recommended vaccines should be covered without copays, deductibles, or other costs, when administered by an in-network provider.No Barriers: Insurers should not put up extra steps that make it harder for people to get vaccinated.Based on Medical Guidance: Vaccines are to be covered if they follow the recommendations of national medical groups like the CDC, FDA, ACOG, AAP, and AAFP. The State Board of Pharmacy recently approved several trusted medical organizations, including the FDA and major physician groups, to set vaccine guidelines in Pennsylvania. This means pharmacists and other providers can follow these updated guidelines when giving vaccines.Encouraged Coordination: This guidance applies to most health insurance plans sold in Pennsylvania, including major medical plans and some limited coverage plans. However, PID also encourages insurers who handle self-funded employer health plans (plans not directly regulated by the state) to make sure vaccine access stays consistent for their members.
PID urges insurers to share clear and accessible information with Pennsylvanians online and through their customer service efforts, so Pennsylvanians know exactly how to get vaccinated.
On Oct. 1, Governor Shapiro signed Executive Order 2025-02, which directs state agencies to safeguard vaccine access across Pennsylvania. The order calls for the creation of a state-based vaccine safety net for children, instructs agencies to align their policies with medical experts, and launches a central vaccine portal. It also establishes a Vaccine Education Workgroup to improve public communication and fight misinformation, protects Pennsylvanians from all ages and strengthens Pennsylvania’s public health leadership.
Importantly, the executive order reinforces that recommended vaccines should remain covered under both private insurance and Medicaid in Pennsylvania. This step ensures that whether someone has a state or private plan, their access to immunizations is protected and consistent.
Consumers with questions or complaints about their health insurance can visit pa.gov/consumer or call 1-866-PA-COMPLAINT (1-866-722-6675).
