The COVID-19 Bridge Access Program for Uninsured Adults (hereafter the Bridge Access Program) is a program that the Centers for Disease Control and Prevention (CDC) will operate from Fall 2023 through the end of December 2024.
Any adult living in the U.S. who does not have health insurance or whose health insurance does not provide zero-cost access to COVID-19 vaccines is eligible to receive cost-free access to COVID-19 vaccines through the Bridge Access Program.
The following definitions apply to the Bridge Access Program:
- Uninsured: Refers to a person who does not have Medicare, Medicaid, or private insurance.
- Underinsured: Refers to a person who has health insurance, but the insurance does not cover COVID-19 vaccines; also, a person whose medical insurance does not provide first-dollar coverage (i.e., copay-free coverage) of COVID-19 vaccinations.
- Awardee: Refers to the 64 CDC immunization programs funded by the core Vaccine for Children (VFC) Program and Immunization Program cooperative agreement who are also recipients of Bridge Access Program supplemental funding. The awardee, in this instance, is the state.
- Low-access area: An area in which a significant number of uninsured persons are far enough from the closest pharmacy, health center, or health department site to make it difficult for those persons to travel to the nearest site to access COVID-19 vaccination service.
- Low-vaccination area: An area in which a significant number of uninsured persons, as defined in the Bridge Access Program, have not yet been vaccinated (with pre-existing COVID-19 vaccines and/or with the updated COVID-19 vaccines).
Awardee Responsibilities and Interactions with Health Centers
- Leverage existing providers enrolled in the awardee’s Adult/317 Program and/or enroll new providers into the Bridge Access Program. Awardees are encouraged to:
- Enroll additional providers in areas with low access to vaccination sites, low COVID-19 vaccination coverage, and/or high uninsured rates or providers serving persons in carceral settings.
- Work to ensure that approximately 25% of Bridge Access Program COVID-19 vaccines are distributed through HRSA-supported health centers.
Overview of Responsibilities for Health Centers
- Enroll as an adult immunization provider in the awardee immunization program.
- Sign a provider agreement with the awardee outlining provider requirements for participation in the awardee’s existing Adult/317 Program, including specific Bridge Access Program requirements.
- Complete and submit to the awardee a provider profile.
- Be familiar with all awardee procedures for ordering, receiving, and administering vaccines in accordance with ACIP recommendations and CDC storage and handling guidelines.
- Permit patients to attest to a lack of insurance at the point of care.
- Continue to collect insurance data through standard patient screening questions and data collection systems (e.g., via the use of an eligibility screening record).
- Not turn any patient away due to inability to pay or verify insurance status.
Cost of Vaccination
- Use American Rescue Plan Act grant funding and HRSA COVID-19 Bridge funding to support COVID-19 testing, COVID-19 vaccination, patient support services, and community outreach.
- Not refuse vaccination to any patient due to the patient’s inability to pay an administration fee.
Vaccine Allocations, Supply, and Ordering
- Order COVID-19 vaccines directly through the awardee immunization program.
- Continue to order testing supplies and therapeutics through HRSA at no cost as long as they are available.
Coordination Across Bridge Program Partners
- Collaborate with the awardee immunization program to support planned outreach opportunities and vaccination events for uninsured and underinsured adult populations.
Community Partnership and Outreach
- Collaborate with the awardee immunization program, awardee-funded partners, and CDC-funded partners to increase COVID-19 vaccine demand and confidence among eligible populations.
- Support COVID-19 outreach and vaccination activities using additional funding sources, as available.
Vaccine Administration Reporting and Monitoring
- Document patient eligibility and report vaccine administration data to the Immunization Information System (IIS), as outlined in the awardee’s provider agreement.
- Register and submit provider location, contact, and vaccine availability data (not inventory) to vaccines.gov to help ensure uninsured and underinsured patients are able to locate cost-free COVID-19 vaccines.
- Submit monthly doses administered data to HRSA via survey mechanism, which will then be shared with the CDC for aggregation and sharing with the public.
Program Data Reporting and Monitoring
- Must submit periodic progress reports based on activities in accordance with the terms as defined in their HRSA COVID-19 Bridge Program agreement.