Most COVID-19 treatment is no longer free for the majority of Americans. The federal programs that once covered testing, vaccines, and antiviral medications at no cost have largely expired or run out of funding. What you pay now depends on your insurance status, the type of treatment you need, and whether you qualify for remaining assistance programs.
What Changed After the Public Health Emergency
During the pandemic, the federal government covered COVID-19 testing, treatment, and vaccines for nearly everyone, including uninsured patients. That changed in stages. The HRSA Uninsured Program, which reimbursed hospitals and providers for treating patients without insurance, stopped accepting new claims in March 2022 due to lack of funds. In June 2023, the Fiscal Responsibility Act rescinded remaining program funds entirely, meaning no additional payments will be made under that program.
The free at-home COVID test program through USPS also ended, with final orders accepted on March 9, 2025. If you still have unexpired tests at home, those work fine, but you can no longer order new ones for free through the government.
What Insured Patients Pay
If you have private insurance, your costs for COVID-19 treatment now follow the same rules as any other illness. That means copays, deductibles, and coinsurance apply to doctor visits, prescriptions, and hospital stays. Insurers are no longer required to waive cost-sharing for COVID-specific care.
Medicare Part D covers oral antiviral treatments like Paxlovid, but standard cost-sharing applies. You’ll pay whatever your plan’s deductible, copayment, and coinsurance rules require. Depending on your specific plan, this could range from a modest copay to a larger share of the drug’s retail price.
Medicaid coverage for COVID-19 treatment varies by state. After federal coverage requirements expired, each state sets its own rules about what COVID-related services it covers and at what cost to patients. Some states cover antiviral prescriptions with little or no copay, while others may have more limited benefits.
Free or Low-Cost Antiviral Options That Still Exist
Paxlovid, the most widely prescribed oral antiviral for COVID-19, has a patient assistance program called PAXCESS run by Pfizer. Through the end of 2024, patients on Medicare, Medicaid, TRICARE, VA Community Care Network, or those who are uninsured could get Paxlovid for free through this program. Commercially insured patients were not eligible. To enroll, patients needed a prescription, basic personal information, prescriber details, and insurance status. Enrollment was available online at PAXCESSPatientPortal.com or by phone.
For Lagevrio (molnupiravir), Merck’s patient assistance program, MerckHelps, provides the medication free of charge to eligible patients. You can check eligibility by calling 1-800-727-5400 or visiting merckhelps.com/LAGEVRIO. The drug is also available through some federal sources at no cost, including HRSA-supported health centers and Indian Health Service facilities.
If you’re uninsured or underinsured, it’s worth calling the manufacturer’s assistance line before assuming you’ll pay full price. These programs exist specifically because the retail cost of antivirals can run over $1,000 without coverage.
Vaccine Costs
COVID-19 vaccines are covered at no cost by most private insurance plans, Medicare, and Medicaid. For children through age 18, the Vaccines for Children (VFC) program provides free vaccines to those who are Medicaid-eligible, uninsured, underinsured, or American Indian/Alaska Native.
For uninsured adults, the CDC’s Bridge Access Program provided no-cost COVID-19 vaccines but was set to end by December 31, 2024. A proposed replacement, the Vaccines for Adults program, was included in presidential budget proposals but had not been enacted as a permanent solution. Without these programs, uninsured adults may face the full retail price of the vaccine, which can be over $100 per dose.
If You’re Uninsured
Uninsured patients face the steepest costs. Without the federal reimbursement programs that existed earlier in the pandemic, you are now financially responsible for COVID-related care, from testing to hospitalization. A course of antiviral medication alone can cost more than $1,000 at retail price, and a hospital stay for severe COVID can result in a bill of tens of thousands of dollars.
Your best options for reducing costs are federally funded health centers. HRSA funds roughly 1,400 health centers operating more than 16,200 sites across every U.S. state and territory. These centers offer care on a sliding fee scale based on your income, meaning you pay what you can afford. You can find the nearest one at findahealthcenter.hrsa.gov by searching your zip code. Many of these sites can prescribe antivirals, administer vaccines, and treat COVID symptoms at reduced or no cost.
Manufacturer assistance programs for antivirals remain one of the most direct ways to get free medication if you qualify. If you test positive and your provider recommends an antiviral, ask about patient assistance before filling the prescription at retail price.
What Hospitalization Costs Look Like
Hospital treatment for severe COVID-19 now follows the same billing structure as any other serious illness. Insured patients pay according to their plan’s rules for inpatient care, including deductibles and coinsurance that can add up to several thousand dollars. Uninsured patients receive the full hospital bill, though most hospitals have charity care programs or financial assistance policies that can reduce or eliminate costs for patients below certain income thresholds. If you’re hospitalized without insurance, ask the hospital’s financial counselor about these programs before discharge.