WI| Governor Tony Evers has directed the Office of the Commissioner of Insurance to clarify that both health insurers and governmental self-funded health plans in Wisconsin must comply with coverage requirements for COVID-19 vaccinations. Following a standing medical order issued by the State Epidemiologist authorizing COVID-19 vaccines for eligible recipients, and consistent with Wisconsin’s anti-discrimination statutes, the Commissioner expects that all group and individual health plans must fully cover vaccination costs for all policyholders without cost-sharing.
Key Points:
- Coverage practices that discriminate among similarly situated insureds without actuarial or medical basis violate Wisconsin law.
- Health insurers and governmental self-funded plans must provide coverage for COVID-19 vaccination without cost-sharing for all policyholders.
- A standing order by the State Epidemiologist allows eligible Wisconsinites, including Medicaid recipients, to receive the vaccine at no additional cost.
