Adult Vaccines Available at Local Pharmacies

Flu; Pneumonia; Tetanus, Diphtheria and Pertussis (Tdap); Tetanus and Diphtheria (Td); Shingles; and Meningococcal Vaccines

Date Issued: 10/26/2016

Flu Vaccines Available

Originally Issued: 5/13/2014 | Updated 10/26/2016

It’s that time of year again. Flu season begins in the fall and often ends in the spring. Getting a flu vaccine 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.

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.

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 Pharmacies

EmblemHealth members ages 18 and over can save time by getting their flu vaccine at a local pharmacy. These pharmacies may be able to provide you with vaccine appointments more quickly and conveniently than your doctor’s office. Be sure to call ahead to make sure your pharmacy is giving flu shots and to make an appointment.

A pharmacist cannot administer vaccines to children in the State of New York. If your child needs a vaccination, you will need to call your doctor.

Flu vaccines are free for most members.

Who is Eligible?

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

You must continue to pay your Medicare Part B premium.

**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 flu vaccine at any other location.

To find a nearby location that participates in the EmblemHealth vaccine program:

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.

Learn more about the flu vaccine by reviewing Flu Facts: Frequently Asked Questions.

Are any other vaccines recommended for older adults available at local pharmacies?

In addition to administering the flu vaccine, some pharmacies are able to provide other vaccinations recommended for older adults.

Pneumococcal (pneumonia) vaccine: Protects against pneumonia and other types of infections caused by the most common strains of a bacterium called Streptococcus pneumoniae. The pneumococcal vaccine is recommended for all adults over 65 years old, and for adults younger than 65 years who have certain chronic health conditions.

Tdap or Td vaccine: Protects against tetanus, diphtheria and pertussis. Every adult should get the Tdap vaccine once if they did not receive it as an adolescent to protect against pertussis (whooping cough), and then a Td (tetanus, diphtheria) booster shot every 10 years. In addition, women should get the Tdap vaccine each time they are pregnant, preferably at 27 through 36 weeks of pregnancy.

Shingles (Zoster) vaccine: Protects against shingles and a painful complication of shingles called post-herpetic neuralgia (PHN). Zostavax is the only shingles vaccine currently approved by the Food and Drug Administration (FDA). The shingles vaccine is recommended for all adults 60 years of age and older.

Meningococcal Vaccine Also Available

A meningococcal vaccine is not recommended for all adults. This vaccine may be recommended for you if you have certain risk factors due to your age, health, job or lifestyle. Talk to your doctor or pharmacist to see if you need this vaccine.

This vaccine is available through local pharmacies as well as in a doctor’s office.

Do I Need a Pneumonia, Tdap, Td, Shingles or Meningococcal Vaccine?

Please ask your doctor or pharmacist if you should receive any of the above vaccines. You can also find out more by reviewing the following information from the Centers for Disease Control and Prevention (CDC):