Flu, Pneumonia And Shingles Vaccines Available

Date Issued: 9/11/2015

Flu Vaccines Available

Originally Issued: 5/13/2014 | Updated 9/11/2015

It’s that time of year again. Flu season begins in the fall and often ends in the spring. Getting a flu vaccine (shot or nasal spray) every year is the single best thing you can do to protect yourself and your family. We make it easy to get your flu vaccine.

Visit Your Doctor

Call today and make an appointment to get your flu vaccine. If the flu vaccine is the only reason for your office visit, it’s free – you won’t have to pay a copayment, deductible or coinsurance.


Note – When you visit your doctor’s office for any other reason and also get a flu vaccine, you will need to pay the copayment, deductible and/or coinsurance for the office visit required for your plan. There may be some exclusions. Please call Customer Service at the phone number on the back of your member ID card to learn more.


Flu Vaccines Available at Retail Pharmacies

EmblemHealth members can save time by getting vaccines at a local retail pharmacy. These pharmacies may be able to provide you with vaccine appointments more quickly and conveniently than your doctor’s office.

Flu vaccines are free for most members. (See chart below)

Why Do I Need a Flu Vaccine Each Year?

The types of flu virus (known as strains) that are around each year can vary. Flu vaccine is made before it is needed based on strains expected in the upcoming season. You will need this year’s flu vaccine to fight this year’s seasonal flu.

Who is Eligible?

  • Commercial members with both medical and pharmacy benefits with EmblemHealth are eligible to get their flu vaccine at participating retail pharmacies.
  • Medicare members who have both Part D and Part B benefits with EmblemHealth can get the flu vaccine at participating retail pharmacies.
  • Medicaid and Child Health Plus members over 19 are eligible to get the flu vaccines at participating retail pharmacies.

Please note that there may be some exclusions. Please call the number on the back of your member ID card if you are unsure if you are covered for these vaccines.

How much will I pay for the vaccines at a retail pharmacy?

Vaccine Commercial Medicare* Medicaid and Child Health Plus (only members over 19 are eligible)**
Flu - Member Copay $0 $0 $0

*Medicare members with Part D (pharmacy) and Part B (medical) benefits with EmblemHealth. Please note: Medicare members with Part D (pharmacy) benefits with EmblemHealth, but no Part B (medical) benefits, cannot get the flu vaccine at a network pharmacy. Those members should contact their Part B carrier for coverage of the flu vaccine.

**Medicaid and Child Health Plus members under the age of 19 must see their doctor to get a free flu vaccine and are not covered for a free vaccine at any other location.

To locate a participating pharmacy:

  • Use the Find a Pharmacy tool to check if your pharmacy is a participating pharmacy.
    or
  • Call the number on the back of your member ID card or our Flu Information Line at
    1-877-859-9001.

Contact your network pharmacy in advance to ask about vaccine availability, age restrictions and current vaccination schedules. Also, don’t forget to present your member ID card to the pharmacist at the time of service.

What kinds of flu vaccines are available?

There are two types of flu vaccines available:

  • The flu vaccine — this is an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is recommended for healthy people six months and older. This includes pregnant women and people with certain medical conditions such as asthma, diabetes and heart disease.
  • The nasal spray — this is a vaccine made with live, weakened flu viruses that are given as a nasal (nose) spray. The viruses in the nasal spray do not cause the flu. This vaccine is recommended for healthy people 2 through 49 years of age who are not pregnant.

Vaccines for Children: The flu vaccine or the nasal spray vaccine is recommended in healthy children. For children younger than nine years old and who have never had a flu vaccination, two doses are needed. The bottom line: Talk with your child’s doctor to see what is needed.

Flu Facts: Frequently Asked Questions


Pneumonia, Shingles and Meningococcal Vaccines

Other vaccines are available at retail pharmacies as well. Members may also receive these vaccinations in a doctor’s office.

Vaccine Commercial Medicare Medicaid and Child Health Plus (only members over 19 are eligible)**
Pneumonia - Member Copay $0 $0 $0
Shingles - Member Copay (only members who are 50 years and older are eligible) $0 Brand Formulary Copay $0
Meningococcal – Member Copay N/A*** N/A*** $0

N/A***: This item is not available through the Retail Vaccine Program. Members that need this vaccine are covered through their medical benefit and should receive it at the doctor’s office.

Do I Need a Pneumonia, Shingles and Meningococcal Vaccine?

Please ask your doctor if you should receive any of the above vaccines. Guidance from the Centers for Disease Control is below.