New COVID Vaccines Arrive In NJ, But Will Insurance Still Cover It?

New Jersey is urging insurance companies to continue their coverage of the COVID-19 vaccines for residents as the updated version arrives in the Garden State.

The state's Department of Banking and Insurance sent out a notice on Sept. 11 to all health insurance companies stating that they expect, "consistent with state law, all carriers to continue to provide coverage without cost sharing for the COVID-19 vaccines and the cost to administer such vaccines, and strongly encourages carriers to provide such coverage without additional barriers, regardless of federal actions relating to the 2025-2026 respiratory illness season."

This notice was filed following the Trump Administration's U.S. Food and Drug Administration(FDA)'s latest policy on COVID-19 vaccines to narrow its use to only individuals 65 years and over or those with certain underlying medical conditions.

In opposition to the federal ruling, the New Jersey Department of Health (NJDOH) issued Executive Directive No. 25-003, allowing anyone six months of age and older to receive a COVID-19 vaccine for the 2025-2026 respiratory illness season.

Related: NJ Removes COVID-19 Vaccine Restrictions Despite FDA Rules

Additionally, a Standing Order was also issued by the NJDOH authorizing pharmacists in New Jersey to administer COVID-19 immunizations without a prescription.

Consistent with state law, insurance carriers are expected to continue to provide coverage for COVID-19 vaccines and the cost to administer the vaccines, without cost-sharing, according to the Department.

One of the leading health insurance agencies in New Jersey, Aetna, told Patch that it plans to continue coverage.

"Aetna continues to provide coverage for approved vaccines, including for COVID-19, in compliance with applicable state and federal cost-sharing requirements. All members of insured plans voluntarily choosing to vaccinate against COVID-19 may do so with no cost sharing. Self-funded plans determine their own insurance coverage as allowed under federal and state laws," a spokesperson with Aetna said to Patch.

Dr. Joshua Ardise, VP and Chief Medical Officer, with Horizon Blue Cross Blue Shield, said they are currently reviewing their COVID-19, RSV and Flu vaccine policies in regards to recent federal immunization recommendations.

"Preventive care, including vaccination, plays a vital role in helping our members achieve their best health. All Horizon plans include access to preventive services that support overall well-being," said Ardise. "As we navigate an evolving health care landscape, maintaining robust immunization coverage continues to be a top priority for protecting both individual and community health. We are currently reviewing our COVID-19, RSV and Flu vaccine policies as related to the recent federal immunization recommendations. Our vaccine coverage decisions will also be guided by evidence-based recommendations from expert organizations such as the American Academy of Pediatrics and American College of Obstetrics and Gynecology, to name a few."

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