Currently, COVID vaccines remain covered for all Partners for Health members at $0 member cost share under both the medical and pharmacy benefits.
It is worth mentioning that health care providers and pharmacies may follow FDA and CDC guidelines when determining clinical eligibility for a COVID-19 vaccination. Based on your age and any applicable health risks, you will need to discuss this with your health care provider or immunizing pharmacist and follow their guidance and recommendations regarding the COVID-19 vaccine.
Coverage Basics
Yes, it’s covered. COVID-19 vaccines remain covered for all members with $0 cost share.
Both BlueCross BlueShield of Tennessee and Cigna cover the vaccine under the medical benefit when given at a provider’s office or through pharmacies that participate in the medical networks.
CVS Caremark also covers the vaccine under the pharmacy benefit through its vaccine network, including CVS pharmacies.
CVS Pharmacy is actively offering COVID-19 vaccinations in many states (including Tennessee).
Access in Tennessee
Tennessee is one of 34 states where pharmacists can administer the vaccine.
No prescription is needed to get vaccinated at a pharmacy.
If a member goes to CVS, they should provide their CVS Caremark prescription card or their medical ID card at the time of service.
Clinical Eligibility
Coverage applies to everyone, but some providers may follow new FDA and CDC guidelines about who should get the vaccine, depending on age and health risks.
Members may need to talk with their provider to confirm eligibility and recommendations.
Key Reassurance for Members
Even though federal guidelines have changed regarding who should be vaccinated, our coverage hasn’t changed. Members will not have to pay out of pocket for it.