The Inflation Reduction Act (IRA) and Affordable Care Act (ACA)* require health plans to cover ACIP-recommended vaccines, including those with shared clinical decision-making (SCDM), at $0 out-of-pocket costs for patients.
For patients 60 years and older who have commercial insurance, it is expected ABRYSVO will be covered by the medical benefit of health plans and billed like any other vaccine in the office.
For patients 65 years and older who have Medicare benefits, ABRYSVO will be covered as a Part D benefit. For these patients, you can verify benefits and adjudicate claims for ABRYSVO through a platform, like TransactRx, or by referring the patient to a local pharmacy with an e-prescription.
If you have questions about patient eligibility, reimbursement, or claims submissions, contact the Pfizer Vaccines Reimbursement Support Services at 1-866-744-3198.
Explore a range of resources related to ABRYSVO, including videos, information about upcoming events, and more.
Explore a range of resources related to ABRYSVO, including videos, information about upcoming events, and more.