Understanding Gardasil 9: Costs, Insurance Coverage, and Savings Tips
Gardasil 9 is a vaccine prescribed for the prevention of certain types of cancers caused by human papillomavirus (HPV), including cervical, vaginal, and vulvar cancer. It can be given to anyone between the ages of 9 and 45, on either a two- or three-dose schedule. You need a prescription for Gardasil 9, but it’s often given during appointments at a healthcare provider’s office.
There used to be three possible HPV vaccines administered to patients, but according to Jared Braunstein, DO, an internist with Medical Offices of Manhattan and contributor to LabFinder, Gardasil 9 is the only one still used in the United States, protecting against nine types of HPV. Without insurance, it could cost about $363 for each dose of the Gardasil 9 vaccine. Many commercial, private, and state-funded health plans cover some or all of the cost of Gardasil 9, but there are ways to save money if you don’t have insurance. Here’s how.
How Much Does Gardasil 9 Cost Per Dose?
Gardasil 9 is a vaccine that needs to be administered two or three times, depending on your age and the dosing schedule recommended by your healthcare provider. The typical cash price of Gardasil 9 per dose is $363, but prices vary. Keep in mind that two, and sometimes three, doses are needed, depending on your healthcare provider’s recommendation.
Factors Influencing the Cost of Gardasil 9
“Your insurance coverage is the primary factor affecting your Gardasil 9 cost,” says Razan Hendi, Pharm.D., consultant pharmacist at DeltaCare Rx. Your vaccination coverage, including copays and deductibles, can impact your out-of-pocket expenses.
“The pharmacy you choose can also impact your cost,” Dr. Hendi says. According to Gardasil 9’s manufacturer, Merck & Co., the cost of receiving Gardasil 9 at a pharmacy may be higher than receiving it in-office with your healthcare provider. Eligibility for a manufacturer coupon or its patient assistance program can also influence the cost of Gardasil 9.
Is There a Generic Gardasil 9?
No, there is currently no generic version of Gardasil 9.
Is Gardasil 9 Covered by Insurance?
Gardasil 9 is typically covered by all types of health insurance plans, including Medicaid and Medicare plans, according to Dr. Hendi. However, your coverage may depend on your age, gender, and any specific vaccination guidelines your plan follows for approval of coverage. It’s always a good idea to check with your individual plan first.
According to Merck & Co., the majority of people with some kind of health insurance don’t pay anything for their Gardasil 9 vaccine. As of 2022:
- Almost 90% of commercially and privately insured patients had no out-of-pocket costs when receiving Gardasil 9 in-office or at a pharmacy.
- More than 96% of Medicare patients paid nothing to receive Gardasil 9 in-office, and more than 83% paid nothing to receive it at a pharmacy.
- More than 99% of Medicaid patients had no out-of-pocket costs to receive Gardasil 9 regardless of where it was administered.
How Much Does Gardasil 9 Cost Without Insurance?
Without insurance, the list price of Gardasil 9 is $363 for a single dose. However, you need to receive two or three doses to be fully vaccinated. In total, you could pay either $726 on the two-dose schedule or $1,089 on the three-dose schedule without insurance.
Although there were two other HPV vaccines approved by the FDA, Gardasil 4 and Cervarix, Gardasil 9 is the only vaccine for the prevention of HPV cancers on the market today. There is no generic alternative.
How to Save on Gardasil 9 Without Insurance
Most insurance plans, including Medicaid and Medicare, offer coverage for Gardasil 9. But even if you don’t have insurance, there are still ways to save.
1. Use a SingleCare Discount Card
The SingleCare prescription discount card can help you save money on Gardasil 9 when presented at a participating retail pharmacy. Instead of paying $363 for a single dose, you could use a SingleCare coupon for your preferred pharmacy and pay about $306. Without insurance, this is one of the best ways to lower the cost of Gardasil 9. Remember, though, that discounts vary from pharmacy to pharmacy, so use your SingleCare prescription discount card to shop around for the cheapest cost in your area.
2. Check Your Eligibility for the Merck Patient Assistance Program
If you don’t have insurance, are between the ages of 19 and 45, and meet certain income requirements, you may be able to get the Gardasil 9 vaccine free of charge through the Merck patient assistance program. In some cases, Merck may grant eligibility to insured individuals if they meet the income requirements and can prove that the vaccine is unaffordable even with insurance.
3. Enroll in the Vaccines for Children Program
The Vaccines for Children (VFC) program is run by the Centers for Disease Control and Prevention and provides free vaccines to uninsured and underinsured children 18 years or younger. Children must meet at least one of the following requirements: uninsured, underinsured, eligible for Medicaid coverage, or of American Indian or Alaska Native heritage.
4. Check with Local Clinics
The American Cancer Society’s HPV VACs (Vaccinate Adolescents Against Cancers) Program is leading HPV vaccination efforts across the country, with a focus on improving adolescent HPV vaccination rates. In some states, you may be able to attend a community health clinic offering Gardasil 9 vaccines or receive them via pop-up clinics at your school, college, or university.
Conclusion
Understanding the options for getting the Gardasil 9 vaccine without insurance can help you make informed decisions about your healthcare. By knowing where to look for discounts and exploring various coverage options, you can manage the cost of this important vaccine. For personalized assistance and to learn more about saving on the Gardasil 9 vaccine, give us a call at 833-942-3776 or ACA inquiries or 833-739-1122 for Medicare-related questions. Our team is available from 6 am to 4 pm PST every weekday and is ready to help.
Please note: This is an informative post meant to provide general information and may not be up-to-date as the healthcare industry is ever-changing. This is not medical advice.