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    v1.0.30
    OpenPayerPolicy UpdatesPreventive Services & ScreeningMississippi Insurance COVID-19 Coverage | OpenPaye…
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    CurrentMississippi Insurance DepartmentPolicy 2021-02

    Guidance Addressing COVID-19 (Coronavirus) Vaccines

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    Guidance to insurance companies on facilitating covered members’ access to COVID-19 vaccines, including cost-sharing, administration reimbursement, eligible locations, out-of-network providers, and separate billing with unrelated encounters.

    Policy Summary
    PayerMississippi Insurance Department
    PolicyGuidance Addressing COVID-19 (Coronavirus) Vaccines
    Policy CodePolicy 2021-02
    Change TypeNo material change
    Effective DateJanuary 27, 2021
    Next Review DateN/A
    Key ActionForego copayments, deductibles, and coinsurance for COVID-19 vaccinations, including when administered by out-of-network providers.
    SourceLink
    POLICY UPDATE CHANGES

    No material clinical or coverage changes in this revision.

    0Member cost-sharing for COVID-19 vaccination
    In/out networkEligible provider types
    SeparateBilling with unrelated encounters
    COVID-19 vaccinesPreventive service

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    COVID-19 Vaccine Coverage and Administration

    COVID-19 vaccine coverage and administration

    COVID-19 vaccine administration is expected to be covered when all applicable conditions below are met.

    • Eligible administration setting: Provider office, urgent care center, hospital, pharmacy, or another location allowed by Mississippi Department of Health or Centers for Disease Control and Prevention requirements.
    • No member cost-sharing: Forego copayments, deductibles, and coinsurance for the vaccination.0 member cost-sharing

      Applies including when the provider is out of network.

    • Administration reimbursement: Reimburse the provider for administration of the COVID-19 vaccine.

      Applies to both in-network and out-of-network providers.

    • Separate billing with unrelated encounter

      • When vaccine administration accompanies a full office visit, emergency department visit, or other encounter not associated with COVID-19 testing, assessment, or treatment, reimburse administration separately if billed separately.

    Policy Background

    COVID-19 is a respiratory illness caused by a novel coronavirus that has had significant public health and societal effects in Mississippi and across the nation. The bulletin addresses the role of health insurance coverage in helping members obtain COVID-19 vaccines and ensuring that vaccine cost does not become a barrier for Mississippi residents.

    Key Definition

    Definitions
    TermCOVID-19
    DefinitionA respiratory illness caused by a novel coronavirus.
    Policy Summary
    PayerMississippi Insurance Department
    PolicyGuidance Addressing COVID-19 (Coronavirus) Vaccines
    Policy CodePolicy 2021-02
    Change TypeNo material change
    Effective DateJanuary 27, 2021
    Next Review DateN/A
    Key ActionForego copayments, deductibles, and coinsurance for COVID-19 vaccinations, including when administered by out-of-network providers.
    SourceLink
    On This Page
    COVID-19 Vaccine Coverage and AdministrationPolicy BackgroundKey Definition