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COVID-19 vaccines

What you should know about the COVID-19 vaccine

Vaccines are an important tool to help communities fight the spread of COVID-19 and help people stay healthy. Research has shown that people who are not fully vaccinated “were 4.5 times more likely than vaccinated individuals to become infected, 10 times more likely to be hospitalized, and 11 times more likely to die from the coronavirus.”1 Vaccines interrupt the ability of the virus that causes COVID-19 to move between people and mutate, so it is important for everyone to get vaccinated as medically appropriate.

We strongly encourage all Humana members to consider getting the COVID-19 vaccine when they are eligible. Talk to your doctor about what is best for you.

Once fully vaccinated, the CDC confirms that, “You can participate in many of the activities that you did before the pandemic.” Review the CDC’s updated guidance on mask usage here.

Until you are vaccinated, to help yourself and others, it is important to continue following the advice of health professionals in order to minimize the chances of catching or spreading the disease. According to the Centers for Disease Control and Prevention (CDC), wearing masks, practicing social distancing, and washing your hands remain the best protections against the virus.

ALERT:


  1. What vaccines are available for COVID-19?

    There are currently 3 FDA authorized COVID-19 vaccines.
    1. The Pfizer-BioNTech vaccine (also known as Comirnaty) is the first COVID-19 vaccine to receive full FDA approval for individuals 16 years of age and older. The vaccine is also available under emergency use authorization (EUA) for individuals 5 through 15 years of age.
    2. The Moderna vaccine is available under EUA for ages 18 and over.
    3. The Johnson & Johnson vaccine is available under EUA for ages 18 and over.

  2. Are the COVID-19 vaccines safe and effective?

    Yes. Per FDA regulations, vaccines haved passed rigorous safety and efficacy trials. According to the CDC, clinical trials of all vaccines must first show they are safe and effective before any vaccine can be authorized or approved for use, including COVID-19 vaccines.

    Safety: “Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history.” Learn how federal partners are working together to ensure the safety of COVID-19 vaccines.

    With regard to the Johnson & Johnson COVID-19 vaccine, the CDC and FDA recommend “women younger than 50 years old should be aware of the rare risk of blood clots with low platelets after vaccination, and that other COVID-19 vaccines are available where this risk has not been seen.” If you received a Johnson & Johnson vaccine, here is what you need to know.

    Additionally, the FDA has issued a news release and updated the label on the Johnson & Johnson COVID-19 vaccine of an increased risk of Guillain-Barré Syndrome, a rare nuerological disorder, during the 42 days following vaccination”. However, the FDA’s release states the Johnson & Johnson COVID-19 vaccine “continues to find the known and potential benefits clearly outweigh the known and potential risks”.

    Efficacy: The CDC states that, “All COVID-19 vaccines currently available in the United States have been shown to be highly effective at preventing COVID-19.” Learn more about the different COVID-19 vaccines.

    Read more from the CDC about the benefits of getting the COVID-19 vaccine.

  3. Who is eligible to get the vaccine?

    According to the CDC, COVID-19 vaccination is recommended for all people aged 5 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. The Pfizer vaccine is currently the only COVID-19 vaccine available for those age 5 through 17.

  4. How is it administered? How many doses will I need?

    The COVID-19 vaccines will be delivered via injection. Some will require 2 doses to maximize their effectiveness. The Pfizer vaccine requires 2 shots administered about 21 days apart. The Moderna vaccine requires 2 shots administered about 28 days apart. It is critical that you schedule and receive the second dose in order to receive the most protection possible.

    The Johnson & Johnson vaccine requires just 1 shot.

  5. Are Booster shots available?

    Yes. The CDC recommends everyone ages 18 and older should get a booster shot as follows:
    • at least 6 months after the Pfizer-BioNTech or Moderna primary series, or
    • at least 2 months after receiving the single dose Johnson & Johnson vaccine.

    It is important to note that eligible individuals may receive any of the authorized vaccines as a booster dose, regardless of which vaccine was originally administered as a primary dose or series. For example, recipients of a Johnson & Johnson primary dose may receive a booster dose of Johnson & Johnson, Moderna, or Pfizer when they are eligible for a booster dose.

    Eligibility for booster shots continues to evolve. Check the CDC’s web page on COVID-19 boosters for the latest information. Eligible individuals considering a booster shot should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.

  6. Where can I get the vaccine?

    • Visit Vaccines.gov to find vaccination providers near you. Learn more about COVID-19 vaccination locations on Vaccines.gov.
    • Text your ZIP code to 438829 or call 800-232-0233 to find vaccine locations near you.
    • Check your local pharmacy’s website to see if vaccination appointments are available. Find out which pharmacies are participating in the Federal Retail Pharmacy Program.
    • Contact your state health department to find additional vaccination locations in the area.
    • Check your local news outlets. They may have information on how to get a vaccination appointment.

    For more information, visit How Do I Get a COVID-19 Vaccine | CDC

  7. What should I bring to my vaccination appointment?

    Remember to bring a government-issued ID with you when you get your vaccination Because age is an important criterion for eligibility in most states, many vaccine providers are requiring a government-issued ID showing date of birth as proof of age.

    Also remember to bring your Humana Insurance member ID card (Humana Medicare Advantage members, bring your original government-issued Medicare card, too) when you get your vaccine in case the vaccine provider requests it. While the federal government is covering the cost of the vaccine for all Americans, some providers may charge a fee for administering the vaccine. There won’t be any cost to you, but having your card will ensure the provider can receive reimbursement for administering the vaccine to you. For more information on costs, see the “Will I be able to get the COVID-19 vaccine at no cost to me” FAQ below.

  8. Are there any side effects from the vaccine?

    It is possible that you will experience some side effects after receiving the COVID-19 vaccine.

    According to the CDC, “After COVID-19 vaccination, you may have some side effects. This is a normal sign that your body is building protection.”1

    Common vaccine side effects highlighted by the CDC range from pain at the injection site to flu-like symptoms. Learn more from the CDC on dealing with these symptoms and when to call the doctor.

    There have been extremely rare incidents of significant allergic reactions reported. The CDC is working with vaccine providers to put safeguards in place for dealing with severe allergic reactions. Learn more about COVID-19 vaccines and severe allergic reactions.

    Note that the CDC and FDA released a statement on the Johnson & Johnson COVID-19 vaccine stating that, “women younger than 50 years old should be aware of the rare risk of blood clots with low platelets after vaccination, and that other COVID-19 vaccines are available where this risk has not been seen.” If you received a Johnson & Johnson vaccine, here is what you need to know.

    After receiving the vaccine, consider signing up for V-safe from the CDC. “V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your answers, someone from CDC may call to check on you and get more information. And v-safe will remind you to get your second COVID-19 vaccine dose if you need one.”

    Learn more about v-safe.

  9. What can I do once I am fully vaccinated?

    According to the CDC, “If you’ve been fully vaccinated:
    • You can resume activities that you did prior to the pandemic.
    • To reduce the risk of being infected with the Delta variant and possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.
    • You might choose to wear a mask regardless of the level of transmission if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if a member of your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated.
    • If you travel in the United States, you do not need to get tested before or after travel or self-quarantine after travel.
    • You need to pay close attention to the situation at your international destination before traveling outside the United States. To learn more about specific travel protocols, here is what you need to know.
    • If you’ve been around someone who has COVID-19, you should get tested 3-5 days after your exposure, even if you don’t have symptoms. You should also wear a mask indoors in public for 14 days following exposure or until your test result is negative. You should isolate for 10 days if your test result is positive.”

    The CDC recommends continued observance of travel protocols and, if you have symptoms of COVID-19, testing and staying at home or away from others.

    Learn more from the CDC about when you’ve been fully vaccinated.


  10. What if I am high-risk or have a specific medical condition?

    If you have concerns due to your health status or a specific medical condition, talk with your doctor about getting vaccinated.

    If you have an underlying or chronic medical condition, make sure you are in communication with your doctor during this pandemic. Getting these conditions well-managed, by staying on top of your preventive and regular medical care, will help to manage your health risk. This is one of the best ways to protect yourself while awaiting the availability of the vaccine.

  11. If someone has already tested positive for COVID-19 antibodies, is a COVID-19 vaccination necessary and why?

    Yes. Individuals who have tested positive for COVID-19 antibodies should still get the COVID-19 vaccine to prevent potential reinfection.

    It is unknown how long the COVID-19 antibodies in a person’s system may offer protection from the virus—and how high the antibody levels would need to be to offer that protection. Additionally, there have been some reports of people getting reinfected with the virus, which indicates that the natural immunity may wear off over time.2

  12. How long should someone wait to get vaccinated for COVID-19 if they’ve already had the COVID-19 virus?

    • In COVID-19 cases that are mild and don’t require hospitalization, an individual should wait through the CDC-recommended isolation period before getting vaccinated. For most people, this means 10 days after symptom onset and resolution of fever for at least 24 hours without the use of fever-reducing medications.
    • For more severe COVID-19 infections that were treated with monoclonal antibodies or convalescent plasma, the CDC recommends a 90-day wait so that your immune system is recovered and ready.3

  13. Is it safe to get the COVID-19 vaccine at the same time as the flu or other vaccines?

    The CDC has confirmed that “You can get a COVID-19 vaccine and other vaccines at the same visit. You no longer need to wait 14 days between vaccinations. Experience with other vaccines has shown that the way our bodies develop protection, known as an immune response, after getting vaccinated and possible side effects of vaccines are generally the same when given alone or with other vaccines.” Learn more about the timing and administration of other vaccines from the CDC here. Learn more about the timing and administration of other vaccines from the CDC here.

  14. Will I be able to get the vaccine at no charge to me?

    Yes. All Food and Drug Administration (FDA)-authorized COVID-19 vaccines will be covered at no additional cost during the public health emergency. Coverage applies no matter where you get the vaccine, including at both in-network and out-of-network providers. It also covers instances in which 2 initial vaccine doses are required, as well as booster shots that are recommended according to CDC guidelines.

    While the $0 cost share applies across Humana’s Medicare, Medicaid, and commercial plans, there are some technical differences with how claims are processed:

    • Humana Medicare Advantage members: Original Medicare is responsible for coverage of COVID-19 vaccinations. Your vaccine provider will submit vaccine-related charges to Medicare and you will not be responsible for those costs.
    • Humana Medicaid and commercial members: The cost of the vaccine doses will be paid for by the federal government. Humana will cover any cost from vaccine providers for administering the vaccine, and there will be no cost share for members.

    Remember to bring your original government-issued Medicare card and your Humana member ID card when you get your vaccine in case the vaccine provider requests it.

    In the unlikely event you require medical treatment due to adverse effects from the COVID-19 vaccine, Humana will cover that treatment in accordance with your policy, just as with any other covered medical service or treatment.

  15. What if I was charged for my vaccine and need to be reimbursed?

    Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, some vaccination providers may charge an administration fee for giving someone the shot(s). If you’ve been vaccinated and you received a bill – either for the vaccine itself or for its administration - you can file for reimbursement directly from Humana.

    Note that there are separate claim forms for the Pfizer, Moderna and Johnson & Johnson vaccines.

    1. Complete all information requested on the appropriate health benefits claim form below:
    2. Enclose the original itemized bill(s) you paid.

    3. Mail the completed form with the original itemized bill(s) to the address on the back of your Humana member ID card.

    Please note that it can take up to 30 days to process the claim, and the reimbursement will be sent as a check to the home address we have on file for you.

  16. Should I be concerned about scams when I’m looking for the vaccine?

    Wherever you get the vaccine, it’s important to confirm the source is safe and reputable to avoid becoming a victim of fraud. A warning from the FBI in December, 2020, provides information on potential indicators of COVID-19 vaccine-related fraud and tips on how to avoid it. View the FBI’s warning here.

    If you’re a victim of a scam or attempted fraud involving COVID-19, you can:



Sources

  1. “Possible Side Effects After Getting a COVID-19 Vaccine,” Centers for Disease Control and Prevention, last accessed July 20, 2021, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html.
  2. “Frequently Asked Questions about COVID-19 Vaccination,” Centers for Disease Control and Prevention, last accessed July 20, 2021, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html.
  3. “Frequently Asked Questions about COVID-19 Vaccination.”

Out-of-pocket costs related to coronavirus treatment

  1. Is Humana covering out-of-pocket costs for treatment related to confirmed cases of COVID-19?

    For the 2021 plan year, Humana will cover out-of-pocket costs for COVID-19 treatment for all Humana Medicare Advantage medical plan members. Members will have no copays, deductibles or coinsurance out-of-pocket costs for covered services for treatment of confirmed cases of COVID-19, regardless of where the treatment takes place. This could include telehealth, primary care physician visits, specialty physician visits, facility visits, labs, home-health and ambulance services.

    Members are encouraged to check their plan documents for details about their 2021 coverage.

    Medicaid plans will continue to follow state requirements for COVID-19 treatment and cost-share waivers.

  2. Why aren’t all plans eligible?

    Not all member plans are eligible.

    Effective January 1, 2021, employer group members’ standard benefits and cost-sharing will apply for COVID-19 treatment.

    Note: This does not apply to Part D-only plan members. Part D-only plan members continue to be eligible for prescription benefits.

  3. Regarding COVID-19 treatment, what medications will Humana cover?

    Humana will cover FDA-approved medications as they become available. This includes Veklury® (remdesivir), which has been approved by the FDA for the treatment of patients with COVID-19 requiring hospitalization. If a member is prescribed non-FDA-approved medications for the treatment of COVID-19, he or she will be responsible for any cost sharing required per his or her plan design. Non-FDA approved drugs are excluded Part D drugs and ineligible for any Part D coverage.

  4. Are these benefits the same from state to state?

    Unless specifically noted, all of the information on this page applies to Humana members nationwide. However, in the event that individual states find themselves facing unique challenges, Humana will work closely with them to help support our members there. See the latest information specific to your state.

  5. Does this impact in- and out-of-network claims?

    Humana encourages members to continue to seek care from the healthcare providers they already know. We will cover eligible members’ copays, deductibles or coinsurance costs for in-network or out-of-network COVID-19-related covered benefits during this time of crisis.

COVID-19 testing

  1. Will Humana cover COVID-19 testing?

    Humana Medicare Advantage and Medicaid members:

    During the public health emergency, there will be no out-of-pocket costs for Humana Medicare Advantage and Medicaid members who receive a US Food & Drug Administration (FDA) approved or emergency use authorized COVID-19 test.

    Humana Commercial Group members:

    Humana Commercial Group members (those who receive insurance through their employers) will be eligible for COVID-19 testing with no out-of-pocket costs when an FDA approved or emergency use authorized COVID-19 test (including at-home tests) has been ordered by a physician or other licensed healthcare professional because the member:

    • has COVID-19 symptoms,
    • has been exposed to someone with suspected or confirmed COVID-19, or
    • requires pre-admission or pre-procedural testing in an asymptomatic individual.

    Humana Commercial Group members may NOT be eligible for coverage of COVID-19 testing for any indications other than those listed above including, but not limited to, the following:

    • Employment (e.g. pre-employment, return to work) or school purposes (e.g. return to school);
    • Entertainment purposes (e.g. prior to a concert or sporting event);
    • General population or public health screening;
    • Physicals (executive or routine);
    • Screening in a congregate setting;
    • Sports participation; or
    • Travel purposes.

    Humana Commercial Group members are encouraged to check their plan documents for more details about their 2021 coverage.

  2. What if a member chooses a testing location that doesn’t accept Humana insurance?

    Humana Medicare Advantage and Medicaid members:

    During the public health emergency, Humana will cover COVID-19 testing performed by out of network providers, without out-of-pocket cost.

    Humana Commercial Group members:

    Humana Commercial group members will not have out-of-pocket costs for covered COVID-19 diagnostic testing performed by an out-of-network provider. Members should refer to Question & Answer #1 in this FAQ and/or their plan documents for additional information regarding coverage for COVID-19 testing.

  3. How can a member submit a test for payment to Humana?

    1. Complete all information requested on the Health Benefits Claim Form, which can be found here, Health Benefits Claim Form, PDF opens new window
    2. Enclose the original itemized bill(s)
    3. Mail the completed form with the original itemized bill(s) to the address on the back of your member ID card
    4. Please note it can take up to 30 days to process the claim, and the reimbursement will be sent as a check to the home address on file
  4. How many tests will Humana cover for each individual member?

    There is currently no limit on the number of COVID-19 tests Humana will cover for each individual member.

  5. Is a referral, authorization or prescription required to obtain the test?

    Humana Medicare Advantage and Medicaid members:

    During the public health emergency, no referral or prior authorization is required for an FDA approved or emergency use authorized COVID-19 test. Humana does not currently require a practitioner order or prescription as criteria for coverage of COVID-19 tests. Testing locations may require an order or prescription. It is recommended that members contact the testing location for details.

    Humana Commercial Group members:

    For coverage to be eligible, an FDA approved or emergency use authorized COVID-19 test must be ordered by a physician or other licensed healthcare professional.

  6. Is there an age restriction for testing?

    Each testing location has its own guidelines on who can get a COVID-19 test. It is recommended that members contact the testing location for details.

  7. How do I know where to go to get an in-person test?

    Use our COVID-19 Testing Locator to find a location near you.

  8. What is the process for administering the test?

    Testing sites have their own protocols for collecting specimens for COVID-19 testing. It is recommended that members contact the testing location for details.

  9. Do I need to schedule an appointment to get tested?

    Whether an appointment is required may vary by testing location. It is recommended that members contact the testing location for details.

  10. How long will it take to receive test results?

    Testing locations have their own protocols for processing and sharing test results with members. It is recommended that members contact the testing location for details.

In-Home Care

  1. Should I cancel my in-home care appointments because of COVID-19?

    No. Your care is important, and it’s vital to maintain coordination with your healthcare providers. If you have a history of recent travel and symptoms like fever, cough or shortness of breath, please consult your healthcare provider. Call ahead before you request a home visit and tell the representative about your symptoms and any recent travel.

  2. What steps is Humana taking to ensure my safety when a nurse practitioner visits my home?

    Supporting our members through this time of uncertainty is important to us. We’re following the most up-to-date advice from the CDC—on hand-washing, disinfection, protective garb and other safety precautions—to keep you healthy.

  3. What is Humana’s Human Care?

    Human Care is what Humana does and provides to make the healthcare experience easier, more personalized and more caring. It is the actions Humana takes and the services that we provide to help make the healthcare experience better for our members. We seek to go above and beyond to make the experience “more human” to deliver what matters most to our members.