COVID-19 Vaccines: What You Need to Know and How Carriers Will Cover It

by | Dec 16, 2020 | Business, Employee Benefits

As we know, the world is facing an unprecedented medical crisis. Throughout this challenging time, your health and safety is our top priority. Together, we can keep our communities healthy and strong.

Important Things to Know About COVID-19 Vaccines

Keeping you up to date on the latest developments for a COVID-19 vaccine is our top priority. It will be an important way to slow the spread of the disease. That’s why we are committed to helping you find vaccine information and get the vaccine. For guidance on the vaccine and your health, talk to your health care provider.  Several trials from multiple companies are happening now, with promising results that you may have read about. It’s also helpful to know that the U.S. Food & Drug Administration (FDA) has a review process that it completes before it will authorize vaccines for emergency use by the general public.

1. Vaccine Approval:

The U.S. Food and Drug Administration has granted Emergency Use Authorization (EUA) to Pfizer, allowing distribution of its new vaccine for COVID-19. This is encouraging news as the vaccine will serve as a vital tool for controlling and eventually ending this pandemic that has caused so much loss, pain, and disruption around the world.

In order to receive EUA, Pfizer enrolled more than 43,000 participants in a phase 3 clinical trial and met required efficacy protocols. In fact, the vaccine showed 95% efficacy. Some clinical trial participants reported fevers, fatigue, muscle aches, and soreness around injection sites. These side effects are normal and a sign that the body is building immunity.

2. What Is Known and What Comes Next:

    • States will receive limited quantities of Pfizer’s COVID-19 vaccine and will make them available to approved vaccine providers.
    • Kaiser Permanente is one provider that has been approved. COVID-19 vaccines will be arriving in the next few days at multiple provider locations.
    • Providers will administer initial vaccines to the populations prioritized by state health departments and CDC guidance, regardless of health plan membership.
    • Health care workers and residents of skilled nursing facilities have been prioritized by federal and state public health departments to receive the vaccine first in phase 1a.
    • The next groups for prioritization are expected to include essential workers, adults with underlying medical conditions, and people over 65.
    • Select providers won’t charge your employees for the vaccine. Vaccine doses purchased with taxpayer dollars are required by the federal government to be given at no cost.
    • Vaccine supply will increase over time, and all adults should be able to get vaccinated later in 2021.
    • Communication channels will remain open with information about who is eligible in each phase of the states’ prioritization process and how people across our communities can receive a vaccination as it becomes available.

3. While Waiting for Vaccine Availability, It’s Recommended We Continue Taking Steps to Stay Healthy and Safe.

Make sure you are following these simple steps to help protect your health:

    • Get a flu shot
    • Make sure doctor visits are up to date
    • Wear a mask
    • Continue to socially distance
    • Wash your hands

4. How Will the COVID-19 Vaccine Be Covered Once It’s Available?

We want to share with you how Carriers are currently projecting they will cover the approved vaccine(s):

Note: Once a COVID-19 vaccine is FDA authorized, Centers for Disease Control and Prevention (CDC) will work with state health agencies to determine where the COVID-19 vaccine will be available and distribution prioritized. (See table below.)

Aetna Aetna will cover COVID-19 vaccine administration fees without cost-sharing, for both in and out-of-network providers, for Commercial and Medicaid members.
Click Here For More Info.
Anthem Blue Cross Anthem is waiving cost-sharing for FDA-approved vaccines when they become available. The cost-sharing waiver includes copays, coinsurance and deductibles.
Click Here For More Info.
Blue Shield of California Blue Shield of California will cover FDA approved or emergency use authorized COVID-19 vaccines without cost sharing, consistent with the requirements of federal law, including the guidelines in the Fourth Interim Final Rule (effective Nov 2, 2020) issued by the US Departments of Labor, Treasury, and Health and Human Services.
Click Here For More Info.
CaliforniaChoice This decision is made by each individual carrier.
Health Net No information posted at this time.
Click Here For More Info.
Kaiser Permanente Kaiser Permanente won’t charge its members for the vaccine. Vaccine doses purchased with taxpayer dollars are required by the federal government to be given at no cost.
Click Here For More Info.
UnitedHealthcare Members will have $0 cost-share at both in- and out-of-network providers through the national public health emergency period.
Click Here For More Info.

Please Note: This information outlines what carriers and health plans are doing regarding premium payments, eligibility, benefits, etc. Information is subject to change as COVID-19 issues arise.

The COVID-19 vaccine situation is changing quickly. The CDC website is the best resource for COVID-19 information, so be sure to visit it regularly.

At United Agencies, we know this is a challenging time for everyone, and we understand the issues and concerns surrounding COVID-19. Don’t hesitate to Contact United Agencies for assistance. We always available to answer any questions you may have and to be of assistance. In the meantime, be well and please stay safe!

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