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COVID-19 Vaccine Coverage

By mid-2021, it is estimated that FDA-approved COVID-19 vaccines will be available to the general public. Under state and federal mandate, vaccines will be provided at no cost to our members during the public health emergency.

Key facts about COVID-19 vaccines during the public health emergency:

  • Multiple vaccines are in varying stages of emergency use authorization review by the U.S. Food and Drug Administration (FDA).
  • As the various vaccines are authorized by the FDA for emergency use, they will be made available based on vaccine supply and federal, state and county distribution plans.
  • Vaccines will be provided at no cost to our members.*
  • Our members can get the vaccine from any service provider that offers it, regardless of whether that provider participates with the health plan’s network.
  • Because supplies of the vaccine are limited, not everyone who is eligible will be able to get vaccinated right away.
  • To find out if you are eligible and to find locations where you can make an appointment for the vaccine, please go to New York state’s "Am I Eligible" tool or call the New York State Vaccination Hotline, 1-833-NYS-4VAX (1-833-697-4829). Please note that wait times may be longer than normal due to high volumes of calls and requests.
NYS Vaccine Eligibility Tool
COVID-19 Vaccine FAQ's

When can I get the COVID-19 vaccine?

We are following the federal, state and county distribution plans for the vaccine. The CDC has said the goal is for everyone to be able to easily get a COVID-19 vaccine as soon as large quantities are available; however, not everyone will be able to get vaccinated right away.

Currently eligible individuals include doctors, nurses and health care workers, residents and staff at nursing homes and other long-term care facilities, people age 65 and over, first responders, school and school district faculty and staff, public transit workers, grocery store workers and public safety workers. Please refer to the New York Department of Health’s website for more details regarding the phased distribution of the vaccine.

The FDA-approved vaccines are a major step toward containing the COVID-19 virus. We are encouraging as many people as possible to get vaccinated as soon as the vaccine is available to them.

Due to rapid changes with vaccine eligibility and availability, we encourage you to use the new “Am I Eligible” tool or call the New York State Vaccination Hotline, 1-833-NYS-4VAX (1-833-697-4829) to determine your eligibility and find locations where the vaccine is available. You will need an appointment to get the vaccine. Older adults or those without internet access can call 211 for assistance with scheduling an appointment. Please note that wait times may be longer than normal due to high volumes of calls and requests.

NYS Vaccine Eligibility Tool

Where can I get the COVID-19 vaccine?

Please refer to the Department of Health’s website to determine where vaccines are available. Please note that based on the distribution plan not everyone is able to get vaccinated at this time.

Will my health insurance cover the vaccination? Will there be a cost to me?

The federal CARES Act requires COVID-19 vaccines to be given at no cost to patients. The vaccine itself has initially been paid for in advance by the federal government. Health insurers will cover the cost for a health care provider to administer the vaccine without a member cost share. It won’t matter whether you go to an in-network or out-of-network provider or pharmacy during the federal public health emergency or the state-declared disaster emergency.

The vaccine administration is covered in full for all members with the possible exception of less than 10 self-funded employer groups that are not required to comply with the CARES Act vaccine requirements.

What do we know about the vaccine products that are coming to the market? 

The vaccines have been developed and tested through clinical trials with an emphasis on safety and efficacy. The FDA has reviewed these trial results and has conducted its own analysis before authorizing these products for emergency use. Many of the vaccines are administered by a shot and several require more than one shot within a specific period of time. Some of these products require storage at very low temperatures which may affect their distribution and availability.

What can I do to stay safe until I can get the vaccine?

Remember to protect yourself and others from COVID-19 by following the 3 Ws:

  • WASH your hands frequently
  • WEAR a mask or face covering to prevent the spread of COVID-19
  • WATCH your distance – keep six feet apart and avoid small and large gatherings 

How can I help to ensure that the vaccine is most effective for me?

Be sure to understand the number and timing of dosages for the particular vaccine product that you receive and adhere to all vaccine requirements. The maximum protection will only be afforded with full compliance. In addition, understand any risks of side effects for the particular vaccine product that you will be receiving so that you can effectively monitor and manage these symptoms, should they occur.

What providers can I receive a vaccine from?

We will follow the state vaccine distribution plan and update providers and locations as the Department of Health updates their guidance. Not all providers will be able to receive the vaccine at this time.

What is Excellus BCBS’s role in the vaccination effort?

Excellus BCBS has a critical role in helping all our members get the vaccine regardless of age or income. This equitable approach means removing barriers to getting the vaccine such as cost and access. The goal is to get as many people as possible vaccinated quickly so we can get through the pandemic. To do that we’ll be partnering with health systems and pharmacies to provide members and employer groups with the information they need.

Education is an important part of the health plan’s role to encourage vaccinations, dispel myths about the vaccine and address members’ concerns. The health plan will also play an important role in educating physicians and providers on proper billing for the vaccines and giving providers access to expert information about vaccine efficacy and safety.

Excellus BCBS is also working to reduce the burden on the health care system by encouraging annual flu shots and promoting practices such as proper mask-wearing, hand-washing and social distancing. Our goal is to improve the health of the communities we serve.

Stay Informed
The best way to stay informed and have access to your coverage is online. Let’s get you set up online today. For help or questions with your insurance plan, call the number on your Member Card for personalized care, or contact us.
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*Members of a select number of “grandfathered” employer groups may need to pay a cost share for the administration of the vaccine. If you are enrolled in a grandfathered group, please consult with your employer’s human resources or health benefits representative for COVID-19 vaccine-related benefits.

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