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Story Publication logo February 24, 2021

A Chicago Clinic Says It Will Stop Charging Patients a $200 Fee for a COVID-19 Vaccine

Image by Manuel Martinez / WBEZ. United States, 2020.

Tracking The Vaccine follows COVID-19 vaccine distribution across a historically segregated city.

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Multiple Authors

This story is supported by the Pulitzer Center.

Update: After this story was published, the clinic said Tuesday evening it would no longer charge patients an up-front appointment fee for the COVID-19 vaccine and apologized.

For months, public officials have said over and over again that the COVID-19 vaccine will be free, with no out-of-pocket cost, to those who want it.

But WBEZ has learned that at least one COVID-19 vaccine provider in Chicago is charging up to $200 for vaccine appointments. And a public agency in Illinois said it has received dozens of calls from people who’ve been asked to pay a fee for their vaccine appointments from various providers.

Michigan Avenue Immediate Care, listed on the vaccine-finding website the city is using, is charging $195 for a so-called vaccine consultation to people who are uninsured, or whose insurance provider is out-of-network, according to one customer and a medical technician at the clinic.

The clinic Monday afternoon defended the fee, saying the consultation is crucial in evaluating patients.

“We’ve had a lot of positive feedback from patients regarding having the time and opportunity to ask a physician open-ended and detailed questions regarding their specific medical issues and how they relate to COVID vaccination,” the clinic said in a statement.

Vaccine providers are allowed to charge administration fees for the vaccine, but should be billing insurance providers, or the federal government if a patient is uninsured, for those fees, not the customer. That’s according to guidance from the Illinois Department of Public Health. The federal government has even carved out specific funds to cover vaccine administration costs. Michigan Avenue Immediate Care said it is billing insurance for in-network patients, but it’s charging uninsured patients or out-of-network patients up front.

Chicagoan Jamie Gentry, a 33-year-old essential worker, said she had spent 16 hours last week trying to book an appointment through ZocDoc, the website the city of Chicago is using to help people find and book vaccine appointments. But when she finally found a slot at Michigan Avenue Immediate Care, she accidentally booked two appointments instead of one, so she called the office to cancel one of them.

“And it was only through that phone call that I found out that there was a short, 15-minute evaluation before the shot, and that for that evaluation I would have to pay a visit fee,” Gentry said.

Gentry said she was told that as a new customer, she’d normally have to pay $300 for the consultation, but that they were running a promotion that would drop the cost down to $195. But, she was told her insurance was out of network, and she’d have to pay the fee up front in order to get the shot.

A medical technician who answered the phone at the clinic confirmed those charges to WBEZ, but could not say whether the clinic would turn someone away if they couldn’t afford the fee.

Under state guidance, they’re technically not allowed to do so.

(Theresa) Eagleson said her department (the Illinois Department of Healthcare and Family Services) has received 40 to 50 calls associated with vaccine administration fees, and she’s working to get those fees reimbursed.

“These providers, whether they’ve gotten them from the state or the federal government, they’re all gotten the vaccine for free,” said Theresa Eagleson, the director of the Illinois Department of Healthcare and Family Services. “So the most they should be charging is an administration fee, and even then, that shouldn’t be happening. That should be something that’s happening between the provider and the insurer. It should not be involving the customer.”

Eagleson said she would encourage vaccine-seekers to push back on fees associated with the vaccine. She said uninsured people can call HFS for assistance if they were asked to pay out of pocket.

Eagleson said her department has received 40 to 50 calls associated with vaccine administration fees, and she’s working to get those fees reimbursed.

The Illinois Department of Public Health and the Chicago Department of Public Health did not give specific information about what people — whether they’re insured or not — should do if they’re asked to pay high consultation fees.

In a statement, the city of Chicago said that no one can be denied a vaccine based on their coverage status or ability to pay an administration fee.

In fact, the city clarified Tuesday, providers should not be charging customers up front for vaccine administration fees, and anyone who does could see their vaccine supply from the city cut off.

“The city of Chicago monitors vaccine administration to ensure no one is charged and that distribution is equitable,” CDPH said in a statement. “The City has communicated to providers that they should not charge for vaccine administration. Any complaints of fraud or misuse are turned over to the Illinois Department of Financial and Professional Regulation.”

On Tuesday evening, after this story was published, Michigan Avenue Immediate Care issued a new statement to WBEZ, saying it had made a mistake charging customers out-of-pocket for vaccine consultations.

“Again this was 100% our bad, and I will own it, 100%, along with our leadership team. We will positively get this right moving forward, with zero exceptions.” — medical director of Michigan Avenue Immediate Care

The statement said in part that it “misunderstood” how reimbursement would work for patients who did not have insurance or were out-of-network. The clinic said it would no longer charge patients directly going forward, and that it was reaching out to past patients who have paid a fee out-of-pocket to offer a refund — and an apology.

“Our Practice Manager is currently reaching out … at this time to the 20 patients (approximately — the 1.3% of the group who received the vaccine in our office) who had out-of-pocket costs over the last 4 weeks. Our office will be reaching out ASAP to process refunds.”

“Again this was 100% our bad, and I will own it, 100%, along with our leadership team,” the clinic’s medical director wrote. “We will positively get this right moving forward, with zero exceptions.”

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