Staying Fit
Respiratory illnesses are surging throughout much of the U.S., and COVID-19 is right in the mix. Data from the Centers for Disease Control and Prevention (CDC) shows that COVID-19 hospitalizations are increasing; so are deaths from the disease — all while new and highly contagious variants are spreading across the globe.
With the concerning trends, doctors and health experts are reminding patients who test positive for COVID-19 that there are prescription treatments that can help keep a mild infection from turning severe.
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“So it's important that everyone who's infected and who is in a high-risk status have access to these medications,” says William Schaffner, M.D., an infectious disease specialist and professor of medicine at Vanderbilt University School of Medicine in Nashville.
However, universal access to free COVID-19 treatments ended on Nov. 1, 2023, when the medications transitioned from the public market to the private one; the federal government is no longer footing the bill for everyone. Instead, patients need to rely on some combination of private insurance, public insurance and assistance programs run by drugmakers to help cover the cost of once-free medications like Paxlovid.
For some people, this shift in coverage bears little to no immediate impact. For others, treating COVID-19 could now come with hoops to jump through and out-of-pocket expenses. It all depends on the type of health insurance you have, explains Jennifer Kates, senior vice president and director of the Global Health & HIV Policy Program at KFF.
Here's what you need to do if you test positive for COVID-19 and are eligible for time-sensitive treatments.
Who will have to pay for COVID treatments?
If you have Medicare or Medicaid or other government insurance
Paxlovid, the most commonly used oral antiviral, will continue to be free through 2024 for people with Medicare or Medicaid through a U.S. government patient assistance program operated by the drug’s maker, Pfizer.
Patients with a prescription for Paxlovid can enroll in the assistance program online at paxlovid.iassist.com or over the phone (1-877-219-7225). Pfizer estimates that the enrollment process takes about five minutes, and it can be done by the patient, a caregiver, a health care provider or a pharmacist at the point of care.
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