BlueCross BlueShield is closely following the latest information regarding COVID-19 vaccines and distribution progress.
The U.S. Food and Drug Administration* (FDA) issued emergency use authorization for Pfizer, Moderna and Johnson & Johnson/Janssen COVID-19 vaccines. Vaccines are being distributed in phases according to state and federal regulations. Please consult your state health department for their vaccine distribution schedule; a list of state health departments can be found here.
The cost of the vaccine itself will be covered by the federal government during the pandemic emergency period. However, there are separate charges for administration of the vaccines, and most health plans are responsible for those costs during the pandemic emergency period. This applies whether you receive the vaccine from an in-network or out-of-network vaccine provider.
Note that federal agencies have asked the public to be aware of potential fraudulent activity as it relates to COVID-19 vaccine distribution. If someone contacts you promising access to the vaccine for a fee, do not share your personal or financial information.
If you have questions about the safety and effectiveness of the vaccines or other clinical aspects such as potential side effects, please visit the Centers for Disease Control and Prevention* (CDC) website or the FDA website.
In addition, please continue to take safety precautions to slow the spread of COVID-19. Wear a mask, wash your hands thoroughly and frequently, practice social distancing, and get a flu shot. The vaccine will be a new and powerful tool in the fight against COVID-19, but the basic safety guidelines remain effective — and necessary.
Can I get COVID-19 from the vaccine?
No. You have to be exposed to the novel coronavirus to get COVID-19. The currently authorized vaccines teach our immune systems how to recognize and fight the virus that causes COVID-19.
I’ve already had COVID-19. Do I still need to get vaccinated?
Health experts recommend the COVID-19 vaccine even for people who have had a COVID-19 infection. Although infection likely provides some immunity to reinfection, we don’t know yet how long natural immunity lasts. So, it’s important to still get vaccinated even if you’ve had COVID-19 to reduce the risk of reinfection—to protect yourself and others around you.
Once I receive the COVID-19 vaccine, will I be immune for life, or will I need to receive future COVID-19 vaccinations?
At this time, it’s still unknown how long immunity from the COVID-19 vaccine will last and whether it will need to be administered more than once, or even on a regular basis, like the flu shot.
Will a COVID-19 vaccine alter my DNA?
The COVID-19 vaccine will not alter your DNA, and none of the approved vaccines interact with your DNA. The approved Pfizer-BioNTech and Moderna vaccines are messenger RNA (mRNA) vaccines; they contain a bit of RNA (ribonucleic acid) that teaches the cells of the body how to make a protein that causes the immune system to make COVID-19 antibodies. The Janssen COVID-19 vaccine (Johnson & Johnson) is a viral vector vaccine that uses a modified version of a different virus (the vector) to deliver important instructions to our cells that trigger our immune system to begin producing antibodies and activating other immune cells to fight off what it thinks is an infection. At the end of the process, our bodies have learned how to protect us against future infection with the virus that causes COVID-19. Viral vectors cannot cause infection with the virus used as the vaccine vector.
Will the vaccine work for everyone?
The COVID-19 vaccines currently available were proven to be highly effective across diverse races and genders. So, across the U.S., every family and neighborhood can expect the same effectiveness and protection.
Do I really need to get both shots?
If you receive a two-dose vaccine such as the PfizerBioNTech vaccine or the Moderna vaccine, getting both doses is crucial to the vaccine working. The first shot starts to build immunity, the second boosts the immune response. By getting both shots, we protect not only ourselves, but those around us. The Janssen COVID-19 vaccine (Johnson & Johnson) is a one-dose vaccine that takes about 2 weeks to produce protective antibodies after injection.
It seems like the vaccine was approved quickly. Is it as safe as other vaccines I’ve gotten?
COVID-19 vaccines have gone through the same rigorous safety assessment as all vaccines before being authorized for use in the U.S. by the FDA. When it comes to safety, you can be assured there have been no shortcuts. The unprecedented speed of the COVID-19 vaccines was due to multiple factors, including past research into these types of vaccines. COVID-19 is caused by the SARS-CoV-2 virus. Research was already underway to prevent past coronavirus diseases such as SARS and MERS and that experience helped jumpstart work on our current vaccines.
If I get the vaccine, are there any side effects?
After vaccination, some people may develop a fever, muscle aches, headache, and/or fatigue. These side effects are related to the activation of the immune system. In most persons they last 1-2 days and don’t require treatment.
If I am allergic to eggs, should I still get the COVID-19 vaccine?
The current COVID-19 vaccines do not contain eggs or any animal products. However, those with a history of severe allergic reactions to eggs or any other substance (i.e., anaphylaxis) are encouraged to remain after vaccination for 30 minutes for observation. You should alert the vaccination team when you go for your appointment.
Are the ingredients safe?
Yes, the currently authorized vaccines were shown to be very safe in large studies. Researchers have studied vaccines for decades and they’ve found that our bodies recognize parts of the virus (not live virus), and then can build a response (antibody) to protect us from the disease. This means the vaccine helps our bodies remember how to fight the virus if we’re infected in the future.
Will the COVID-19 vaccine cause infertility?
The COVID-19 vaccine, like other vaccines, works by training our bodies to develop antibodies to fight against the virus that causes COVID-19, to prevent future illness. There is currently no evidence that antibodies formed from COVID-19 vaccines cause any problems with pregnancy. In addition, there is no evidence suggesting that fertility problems are a side effect of ANY vaccine. People who are trying to become pregnant now or who plan to try in the future may receive the COVID-19 vaccine when it becomes available to them. Consult with your fertility or pregnancy care team if you have additional questions.
Why do I have to wear a mask even after getting the vaccine?
The current vaccines protect against severe illness and death from COVID-19. It takes several weeks for the full effect of the vaccines to develop and provide you protection from illness. In addition, we only have early information on whether the vaccines prevent virus transmission from person to person.
Why do I need the vaccine if everyone around me is getting it?
Herd immunity and community protection is the ultimate goal, right? Yes, but that’s achieved when a large portion of our entire population has been vaccinated. Current estimates are that at least 85% of our population will need to be vaccinated for COVID-19. Many adults have medical conditions that will prevent them from getting the vaccine even if they want it. So, it’s up to us to keep them protected by doing our part and getting the vaccine for them.
*The Centers for Disease Control and Prevention and the U.S. Food & Drug Administration are independent organizations that provide health information you may find useful.
COVID-19 Related Benefits Information for Members
What kind of support does BlueCross offer?
If you have questions about getting care during the pandemic, using your benefits or managing your health, we are here to help you. You may be contacted by BlueCross to introduce programs that are right for you. To reach us, simply call the customer service number on the back of your member ID card.
Are the coronavirus test and treatment covered under my insurance?
If you have COVID-19 symptoms or if you have been exposed to someone who has tested positive for the virus, your doctor can order a medically necessary test at no cost to you.
Any coronavirus testing not ordered by your doctor or that is not medically necessary will not be covered under your insurance. Public health and employment return to work testing are not considered medically necessary and will not be covered.
Most employer-sponsored health plans have waived all out-of-pocket costs for in-network COVID-19 medical treatment for members. Please contact customer service to confirm coverage for your plan.
Are at-home diagnostic tests covered?
On December 15, 2020, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the first over-the-counter (OTC) fully at-home diagnostic test for COVID-19. The Ellume COVID-19 Home Test is a rapid, lateral flow antigen test, a type of test that runs a liquid sample along a surface with reactive molecules. The test detects fragments of proteins of the SARS-CoV-2 virus from a nasal swab sample from any individual 2 years of age or older.
Because this test is conducted entirely at home, it will not be covered by insurance – similar to other OTC products. However, if you have a Flexible Spending Account or Health Savings Account, the test is considered an eligible expense.
Are there any prior authorizations required for COVID-19 treatment?
BlueCross has waived prior authorization for diagnostic tests and related services for members diagnosed with COVID-19. These tests and services must follow CDC guidelines.
How long do I have to file claims or appeals?
The Department of Labor and the IRS are offering more relief to those enrolled in an employer-sponsored health plan. You now have an extra 60 days after the COVID-19 pandemic emergency period is over to:
- Submit a claim for out-of-network services – This could come from you or directly from your provider.
- Appeal a claim – You can also submit claims or an appeal for any service on or after March 1, 2020 that normally would have expired. We will review your request based on your current plan benefits.
Is it safe to go to a doctor's office right now?
Generally speaking, yes. Most providers’ offices have implemented additional safety measures such as mask requirements, temperature checks, pre-appointment screening questionnaires and social distancing in waiting rooms.
Many providers are also offering virtual visits via video or telephone to accommodate non-urgent medical needs and behavioral health consultations. You would pay your normal cost-share as you would for an in-person visit. The Centers for Medicare & Medicaid have adjusted rules for telehealth services, which can be provided using Skype, FaceTime and similar applications. No formal approval process is needed.
If I have an upcoming preventive care visit or screening, should I go?
Yes. It is still important to attend annual wellness checkups, immunization appointments and well-child visits. If there is not a pressing need, you can talk to your doctor about rescheduling. However, delaying preventive care such as mammograms or colonoscopies is not recommended as it may also delay a potentially serious diagnosis.
Is there chance the hospital or provider will cancel my procedure? If so, what are my options?
If your procedure is canceled, it is likely for good reason. Elective surgeries or procedures may be postponed or rescheduled to free up space or ensure adequate staff. Your doctor can help you determine whether it is safe to delay a procedure and may present other options.
How can I avoid trips to the pharmacy?
If you have mail-order pharmacy benefits, you are encouraged to consider using them. If you have a concern about running out of medications, we recommend you contact your doctor or pharmacist.
*The U.S. Centers for Disease Control and Prevention is an independent organization that provides health information you may find useful.
Coronavirus Disease 2019 (COVID-19)
COVID-19 is a respiratory disease caused by a new coronavirus. Coronaviruses are a large family of viruses that may cause illness in people. The name of this new respiratory disease is coronavirus disease 2019, abbreviated as COVID-19.
According to the U.S. Centers for Disease Control and Prevention* (CDC), COVID-19 can affect anyone and can cause symptoms ranging from mild to very severe. The presence of many chronic conditions worsens the outcome of COVID-19 infection. If you have diabetes, obesity, high blood pressure or lung disease, your likelihood of experiencing complications due to COVID-19 infection is increased. It is more important than ever to manage your condition and take extra precautions to stay safe.
Symptoms of COVID-19 include fever, cough and shortness of breath. Symptoms may also include chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or sense of smell. These symptoms may appear two to 14 days after exposure to the virus. This list is not all-inclusive. Please consult your medical provider about any other symptoms that are severe or concerning to you.
How is the virus passed from one person to another?
Someone who is actively infected with COVID-19 can spread the illness to others even if he or she has no symptoms.
The virus spreads from one person to another through respiratory droplets. These droplets are produced when someone with the illness coughs, sneezes or talks. The droplets can be inhaled, land in the mouths or noses of people nearby and can persist for up to a couple of days on some surfaces. It generally takes close (less than 6 feet away) contact to become infected.
How can I prevent the spread of the coronavirus or other respiratory viruses?
The best way to prevent illness is to avoid being exposed to the virus. To limit virus exposure, the CDC recommends that you:
- Maintain good social distance (at least 6 feet) from others and avoid close contact with people who are sick.
- Cover your mouth and nose with a cloth face covering when around others.
- Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, after going to the bathroom; before eating or preparing food ; and after blowing your nose, coughing or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60 percent alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
- Always wash hands with soap and water if hands are visibly dirty.
- Avoid touching your eyes, nose and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
What should I do if I may have been exposed to or think I am sick with COVID-19?
If you develop a fever and symptoms of respiratory illness, such as a cough or difficulty breathing, or if you have been in close contact with a person sick with COVID-19, contact your doctor before you attempt to see anyone in person. You can tell your health care provider your symptoms and he or she can give you instructions on how to get your medical needs addressed while minimizing the risk of exposure to yourself and others.
There currently is no cure for this virus, so managing mild symptoms at home may be your best option to prevent further spread of the disease. Of course, should you have life-threatening symptoms such as trouble breathing, call 911 or go to your nearest emergency room. If possible, put on a face mask before seeking emergency medical care.
People who are mildly ill with COVID-19 can isolate at home during their illness. When under home isolation, you should:
- Stay at home, except for getting medical care.
- Do not go to work, school or public areas.
- Avoid using public transportation, ride-sharing or taxis.
- Separate yourself from other people and animals in your home and avoid sharing personal household items.
- Monitor your symptoms and seek medical care if your illness gets worse.
Should you have life-threatening symptoms such as trouble breathing, call 911 or go to your nearest emergency room. If possible, put on a face mask before seeking emergency medical care.
*The U.S. Centers for Disease Control and Prevention is an independent organization that provides health information you may find useful.