Marketplace coverage & Coronavirus

• Discover what Marketplace plans cover. All Marketplace plans cover treatment for pre-existing medical conditions and can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19.
• Check with your health insurance company for their specific benefits and coverage policy.

COVID-19 vaccines

If you've never had a COVID-19 vaccine

• Anyone 5 years or older who's unvaccinated can get 1 shot of the updated vaccine.
• Children 6 months through 4 years of age who are unvaccinated can get either:
  • 2 shots of the updated Moderna vaccine
  • 3 shots of the updated Pfizer-BioNTech vaccine

If you've already had at least 1 shot of the COVID-19 vaccine

• Anyone 5 years or older can get 1 shot of the updated COVID-19 vaccine, at least 2 months after getting the last shot of any COVID-19 vaccine.
• Most people who are moderately to severely immunocompromised (like if you had an organ transplant and are at risk for infections and other diseases) may get additional shots of the updated COVID-19 vaccine. Your health care provider can determine if and when you should get additional shots of the updated vaccine.
• Children 6 months through 4 years who got COVID-19 vaccines before September 12, 2023, should get 1 or 2 shots of the updated COVID-19 vaccine. The number of shots from the updated COVID-19 vaccine they can get depends on the vaccine and the number of shots already received.

If you recently had COVID-19

• It’s still important to stay up to date with your vaccines. Talk with your health care provider about what timing is right for you.
• Decide if you want to delay getting the updated COVID-19 vaccine by 3 months. Getting COVID-19 again is less likely in the weeks to months after you had COVID-19, but there are certain reasons why you may want to get the updated COVID-19 vaccine sooner than 3 months, like:
  • Your personal risk of severe disease
  • Risk of disease in a household member or close contact
  • Local COVID-19 hospital admission level
  • The most common COVID-19 variant currently causing illness

If you paid to get a COVID-19 vaccine

• Check receipts and statements for any mistakes.
• Check if your provider is in-network with your health insurance plan. Plans only have to cover the full cost of the vaccine if you get it from an in-network provider.
• Call your provider's office to ask about any changes you think are incorrect. They may help you better understand the services you got, or realize they made a billing error.
• Review your “Explanation of Benefits.” Report anything suspicious to your insurer.

COVID-19 diagnostic testing

• COVID-19 diagnostic tests done at a doctor’s office or other health care provider
• At home COVID-19 tests you buy online or at a pharmacy or store

If you need medical care

• Wait in your car until the start of the visit
• Use a limited entrance
• Be screened for COVID-19 by having your temperature checked
• Avoid waiting rooms and areas
• Maintain social distancing
• Wear a face covering, which will be provided to you if you don’t have your own
• Wash your hands or use hand sanitizer

For the latest COVID-19 information