How to avoid $1,000-plus Paxlovid bills if you get COVID

When Medicare recipient and Commack resident Sylvia Grossbach got COVID-19 while in California in June, she was shocked when she was billed $750 for the anti-COVID medication Paxlovid. 

Grossbach, 81, reluctantly paid, but she later checked online and discovered a federal program that provides free Paxlovid for many Americans. She was reimbursed.

"Luckily I’m computer-literate, but many seniors aren’t," she said.

Programs that provide free Paxlovid doses to many patients have been extended through 2026, manufacturer Pfizer said. But with some pharmacists unaware of the programs, or of who qualifies for them, consumers must be proactive in asking about eligibility to avoid bills that could exceed $1,000 for a five-day supply, pharmacists say.

The drug dramatically reduces the chances of death or hospitalization for those at higher risk for severe illness, multiple studies have concluded — although it makes less difference for vaccinated people, who already have lower rates of hospitalization, research has found.

COVID-19 hospitalizations are rising on Long Island and nationwide, part of an annual increase during the holidays, although hospitalizations and deaths are lower than last year and many times lower than the first four winters of the pandemic. Even so, about 850 New Yorkers had died of COVID-19-related causes in 2025 as of mid-December, according to incomplete Centers for Disease Control and Prevention data. That's down from 1,905 in 2024 and a fraction of the 16,198 who died in 2020.

The federal government initially provided Paxlovid for free to everyone and continued to pay for the drug for all Medicare and Medicaid patients until March 1, when it began requiring copays for some Medicare recipients.

Medicare and Medicaid recipients with annual incomes of $46,950 or less for an individual and with a plan that requires high copays can still receive the drug for free, a Pfizer spokesman said in an email. That program was set to expire Dec. 31 but was extended through 2026, he said.

The Department of Health and Human Services did not respond to requests for comment about Paxlovid discounts.

The program can save Medicare recipients hundreds of dollars off the list price for Paxlovid, which costs up to $1,660 for five days when purchased with a GoodRx coupon — although those who use their insurance rather than GoodRx to buy the medication often are charged much less.

Even so, Grossbach said, many seniors would balk at paying the $750 she was initially charged, which is why, she said, it's important to increase awareness of assistance programs. "For someone my age who has other medical issues, COVID can be dangerous if you don’t take it," Grossbach said.

The Centers for Disease Control and Prevention recommends the medication for anyone 50 or older or with health conditions such as obesity, diabetes and cardiovascular disease. Paxlovid must be taken within five days of the onset of symptoms.

Grossbach said when she had COVID-19, she asked the pharmacist in Oakland, California, if there's a discount program for Paxlovid, but he said he was unaware of one and that although her Medicare drug plan covers Paxlovid, she’d have to pay $750.

Grossbach said when she returned to Commack, she called three local pharmacies to check whether they knew about the federal program, but none did. 

Pfizer said in a statement its Paxlovid advertisements note that many people can receive the drug for free.

They include uninsured patients and those being treated at certain federally funded health facilities. Pfizer also funds copays for many people with private insurance who sign up for the company’s savings program and who get the medication from participating pharmacies.

The Pharmacists Society of the State of New York sends out notices to members of discount and no-cost programs, but the emails "may fall through the cracks," said Danny Dang, the group’s chairman. 

If pharmacists are unaware of a patient-assistance program, they often search for one, but if they don’t, the customer should inquire, said Kurt Proctor, senior vice president of strategic initiatives at the National Community Pharmacists Association.

"The pharmacists are not going to know it off the top of their head, but they know where to look for it," he said.