New Jersey has directed health insurers to provide full coverage of COVID-19 vaccines without cost-sharing for the 2025-2026 respiratory illness season. The state also authorized pharmacists to administer the vaccines without a prescription.
This move places New Jersey among several states choosing not to follow a new federal policy that restricts access to COVID-19 vaccines mainly to individuals aged 65 and older, or younger people with certain health conditions such as asthma. Under the federal approach, most adults under 65 would need an underlying condition to qualify for a booster shot.
The shift in national policy was announced by U.S. Health and Human Services Secretary Robert Kennedy Jr. on August 27, who said the U.S. Food and Drug Administration had approved updated COVID-19 booster shots for fall distribution but only for specific groups.
Following this announcement, acting Health Commissioner Jeffrey Brown issued an executive directive reaffirming that New Jersey continues to recommend vaccination for everyone over six months old, citing scientific evidence supporting broad immunization.
To address questions about insurance coverage after the FDA’s decision, the New Jersey Department of Banking and Insurance (DOBI) released a bulletin instructing carriers to maintain full vaccine coverage without patient cost-sharing for anyone aged six months or older.
Additionally, on September 8, the state Department of Health issued a standing order allowing pharmacists to provide COVID-19 vaccinations and boosters to anyone over age three without requiring a prescription. Children between six months and 36 months will continue receiving vaccinations through their pediatrician’s office.
“New Jersey is committed to ensuring access to the COVID-19 vaccine for all who want one,” DOBI Commissioner Justin Zimmerman said Thursday. “The Department expects that carriers will continue to cover the vaccine for New Jersey residents without cost sharing and is strongly encouraging carriers do so without imposing additional barriers.”
DOBI has also told insurance carriers to update plan documents as necessary and clarify online how residents can access vaccination benefits. For plans not regulated by the state but administered by these carriers, DOBI expects them to encourage plan sponsors toward compliance with its bulletin.
