Covid vaccines are on their way back this fall, but getting one may not be as simple — or as cheap — as before.
On Wednesday, Aug. 27, the Food and Drug Administration approved the updated shots, but for a smaller group of people, focusing on older adults and those with certain medical conditions.
That shift could change what insurance covers, leaving some Texans facing surprise copays or even full out-of-pocket costs that run more than $100.
Here’s what to know about the anticipated changes.
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Who will still be eligible for Covid shots in Texas?
Older adults and people with health conditions like cancer, diabetes, or heart disease are expected to remain fully eligible under the new guidance. Healthy children and adults won’t be barred from getting the vaccine, but doctors would be prescribing it outside the official CDC recommendation.
In those cases, coverage becomes less certain — it depends entirely on what your insurance provider decides.
Will private health insurance cover Covid vaccines in 2025?
Private insurance companies, including employer-sponsored plans and Affordable Care Act marketplace plans, usually base their coverage on CDC recommendations and other medical groups.
Commercial insurance providers are required to cover vaccines on the Advisory Committee on Immunization Practices (ACIP) schedule at no cost-sharing or copay, according to the Affordable Care Act. The ACIP is scheduled to meet on Sept. 18 and 19 to recommend vaccine schedules.
If the ACIP follows the FDA’s new recommendations, healthy patients under 65 who don’t have any underlying conditions may have to pay out-of-pocket for the COVID vaccine. Coverage could vary from one company to the next.
Are Medicare and Medicaid still covering the Covid vaccine in Texas?
Coverage depends on the program.
• Medicare: Yes. Fully FDA-approved Covid vaccines recommended by the CDC remain covered at no cost for Medicare beneficiaries in Texas.
• Medicaid and CHIP: Not as fully. As of Oct. 1, 2024, Texas Medicaid and CHIP stopped covering vaccines that are only authorized under FDA’s Emergency Use Authorization. They still cover administration fees for fully FDA-approved vaccines, but not the EUA versions.
Children can continue to receive free vaccines through the Texas Vaccines for Children (TVFC) program, which offers both FDA-approved and EUA shots at no cost.
How much does the Covid vaccine cost without insurance?
The CDC lists the Covid vaccine at around $137 to $142 in the private sector per dose for adults as of Sept. 1, 2025.
Pharmacies like Walgreens and CVS generally verify coverage before administering vaccines.
That means most people will know ahead of time whether their insurance covers it, requires a copay, or if they’ll be paying out of pocket.
Can you get the flu and Covid shots together this year?
Yes, and many Texans already prefer to do so. Pharmacies and doctor’s offices allow patients to get both vaccines during the same appointment.
But experts worry that confusion over Covid shot coverage could discourage some people from getting either vaccine. Doctors stress that older adults and people with health conditions shouldn’t wait.
What should Texans do before scheduling a Covid vaccine appointment?
If you’re 65 or older or have an underlying condition, your vaccine should still be free this fall through Medicare, Medicaid or most private plans.
If you’re younger and healthy, call your insurance company before making an appointment to ask whether the Covid shot will be covered, and if you’ll face a copay.
For uninsured Texans, the full price may apply unless you qualify for federal programs that offer vaccines for free through select pharmacies and community health centers.