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COVID-19 Frequently Asked Questions

Funds’ COVID-19 Vaccination and Testing Frequently Asked Questions

These FAQs are based on the best available information we have at this time. COVID-19 vaccination and testing supply and eligibility vary across the country. We will do our best to provide our beneficiaries the latest information in a timely manner. This page will be updated as new information becomes available; please check back often. This page was most recently updated on 07/12/2022.

The Funds is committed to the health and safety of Funds’ beneficiaries.

Following is important information related to common questions regarding the COVID-19 Vaccine and testing

We understand there are concerns about the safety of the COVID-19 vaccines. The U.S. Food and Drug Administration (FDA) undertakes a rigorous evaluation of the scientific information through all phases of the clinical trials of a vaccine. This rigorous evaluation process continues after a vaccine has been approved by FDA or authorized for emergency use.

The FDA has approved two vaccinations for the prevention of COVID-19 disease. The FDA has authorized the use of the Pfizer-BioNTech COVID-19 and the Moderna COVID-19 vaccine for individuals 6 months of age and older.  The FDA finds these vaccines are also safe and effective as they continue to evaluate safety data from clinical trials and may approve additional vaccines in the future. We are confident in the FDA’s approval process for Pfizer and Moderna COVID-19 vaccinations.

On rare occasions, some people have experienced a reaction to the injection. If you have concerns due to reactions you have had to a vaccine or injectable therapy for another disease, have been recently immunized for other diseases, or have recently received antibody therapy for a COVID-19 illness, ask your doctor if you should receive a COVID-19 vaccine.  Your doctor will help you decide if it is safe for you to be vaccinated.

As a reminder, you cannot develop COVID-19 from these vaccines.

The FDA has determined that there is a risk of blood clots following administration of the Janssen (Johnson and Johnson) COVID-19 Vaccine and has now limited the authorized use of the Janssen COVID-19 Vaccine. The FDA has limited the use of the Jansen COVID-19 Vaccine to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate and/or who elect to receive the Janssen COVID-19 Vaccine because they would otherwise not receive a COVID-19 vaccine.

 

All states are open for vaccine eligibility and have pre-registration systems available. Please find contact information for your state here.

 

Appointments are strongly recommended to receive a vaccination at CVS, other retail pharmacies as well as mass vaccination sites. Customers will be able to schedule their vaccinations—both the initial shot and the required second dose—here or through the CVS app.  Some sites are offering a phone number to call if you don’t have access to the internet. You can call the Funds’ call center at (800) 291-1425 to get help getting an appointment for your vaccine.

 

All the major national chains and several regional chains are helping the government administer as many vaccinations as possible. Pharmacies participating in the administration of the vaccine once it is broadly available can be found here.

The federal government will cover the cost of the vaccine. The Funds will cover the cost for the health care provider to administer the vaccine. There will be no cost to beneficiaries. If your healthcare provider asks for your health insurance information, please show them your Funds health insurance card.

 

Two vaccines (Pfizer-BioNTech and Moderna) that have been authorized to date require two injections for the initial “primary” series, it is important that you receive both injections if you received either the Pfizer or Moderna COVID-19 vaccine. For optimal protection, a booster is now recommended.

 

For more information about vaccines, including booster shots, visit the CDC’s COVID-19 vaccines page here

A COVID booster shot is an additional dose of a vaccine given after the protection provided by the original shot(s) has begun to decrease. The booster is designed to help people maintain their level of immunity for longer. The FDA recommends booster shots for all individuals. The Pfizer-BioNTech booster is recommended at least 5 months after the completion of the primary series to individuals 5 years of age and older. The Moderna booster is recommended at least 5 months after the completion of the primary series to individuals 12 years of age and older.

Persons who are considered at risk, those who received 2 doses (1 primary dose and 1 booster) of the Janssen (Johnson and Johnson) COVID-19 Vaccine, and persons who are 50 years of age or older are eligible to receive a second booster dose. For more information about booster shots, visit the CDC’s COVID-19 vaccines page here.

The FDA also authorized the use of a “mix and match” booster dose for currently available (i.e., FDA-authorized or approved) COVID-19 vaccines.

You may choose from the Pfizer-BioNTech or Moderna COVID-19 when receiving a booster shot. Some people may prefer the vaccine type that they originally received, and others may prefer to receive a different booster. CDC’s recommendations now allow for this type of mix and match dosing for booster shots. Review the CDC recommendations here

If you received the Janssen Vaccine as your primary dose, you may choose from the Pfizer-BioNTech or Moderna COVID-19 when receiving a booster shot.

COVID-19 vaccines are working well to prevent severe illness, hospitalization, and death, even against the widely circulating variants. However, public health experts are starting to see reduced protection, especially among certain populations, against mild and moderate disease. Individuals are considered optimally vaccinated two weeks after their primary series and are considered up to date after receiving their booster dose.

 

As with vaccines for other diseases, people who are up to date are optimally protected. The CDC now recommends that all individuals receive a booster dose after their primary series when eligible.

For more information about the booster shot, visit the CDC’s COVID-19 vaccines page here

The CDC has issued new guidelines for fully vaccinated adults. You can find the new guidelines here.

Starting January 15, 2022, beneficiaries can obtain FDA authorized COVID self-test kits at a participating preferred pharmacy at no cost.  The test kits must be purchased at the pharmacy counter of a participating pharmacy with your prescription benefit ID card to receive them for free.  For help locating a participating pharmacy or retailer please contact CVS Customer Care at 1-800-294-4741.  We suggest that you call the pharmacy ahead to make sure they have the test kits in stock and are participating with this program.  Please note that only self-test kits purchased after January 15, 2022 that are authorized by the FDA will be covered at no charge. Please refer to this list of FDA authorized test kits.  No prescription is needed for this benefit. Additionally, starting February 15, 2022 you may order kits online at CVS.com and pick them up at your local CVS store.  Information on this program is available here.

If you purchase a test kit from a non-preferred pharmacy or online retailer starting January 15, 2022, you will need to pay for the test at the time of purchase and obtain a receipt for proof of purchase.  To request reimbursement, you will need to submit the original receipt and a completed, signed claim form for each family member that purchases a test.  The Funds will reimburse you up to $12 per individual test and up to $24 if you buy a two-pack of tests.  The required claim form is available here.  You may also submit your claims online at caremark.com.

Information on submitting your claims online is available here.

The COVID self-test kit benefit will cover up to 8 individual tests, per beneficiary, every 30 days at no cost.  This benefit is available throughout the Public Health Emergency (PHE).  Plans are not required to provide coverage of testing (including an at-home over-the-counter COVID-19 test) that is for employment purposes.

COVID testing sites are located nationwide in health centers and pharmacies. To find a COVID testing location near you, please visit the CDC webpage on COVID testing here.

There is no cost for you to have COVID testing performed at health centers and pharmacies.  To find a COVID testing location near you, please visit the CDC webpage on COVID testing here.

Beginning January 19, 2022, free self- test kits can be ordered on-line from the U.S. government here

If you receive a positive result from any COVID test, you should isolate yourself immediately and contact your medical provider for further instructions.