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Seasonal and Preventive
Vaccines

Female is getting vaccine at doctor's office.

Getting vaccines, like flu, COVID-19, or RSV, is one way you can protect yourself, your family, and others from respritory illness.

A beautiful family laugh together as they have their family laughing together outside in cold weather.

Children, adults over 65, and people with chronic conditions such as asthma are at a higher risk of complications from respiratory illnesses. Vaccination is also important for people who are pregnant or have recently had a baby.

Viruses can change quickly, so you will need this year’s vaccines to fight this year’s flu or COVID-19 strains. Talk to your doctor about the right time for you to get seasonal vaccines. Depending on your age or other health conditions, they may also recommend other vaccines, like the respiratory syncytial virus (RSV), pneumonia, or shingles vaccines.

Flu

Influenza (flu) is a contagious respiratory virus that can cause mild or severe illness. Getting a yearly flu vaccine is an important way to help keep you and your family safe and healthy.

How do I get tested for the flu?

Like other tests, your doctor can determine if you need to be tested for the flu based on your symptoms.

Where do I get the flu vaccine?

The flu vaccine is usually available beginning in September and, depending on your plan, you can get it:

At your doctor’s office: Just make an appointment. If the vaccine is the only reason for your office visit, it’s free.

At your pharmacy: Most EmblemHealth members* can get the flu vaccine covered at participating pharmacies. Medicaid and Child Health Plus members over the age of 2 are also eligible. If you are unsure of your flu vaccine coverage, please call the number on your member ID card.

*Medicare members with only EmblemHealth Part D (pharmacy) benefits cannot get the flu vaccine covered at an in-network pharmacy. Those members should contact their Part B carrier for coverage of the flu vaccine.

What treatments are available for the flu?

Most people with the flu get better by resting and managing their symptoms. But some people need more help. Speak to your doctor to find out what treatments may be available to you.

COVID-19

While the COVID-19 Public Health Emergency ended on May 11, 2023, COVID-19 is a virus that continues to spread and make people sick. It’s important to know how to use your plan to get the testing and care you need. Make sure you review your plan’s benefits by signing in to the member portal at my.emblemhealth.com to see what is covered. You may have to pay your copays, coinsurance, and/or deductibles according to your plan’s benefits.

How do I get tested for COVID-19?

Like other tests, your doctor can determine if you need to be tested for COVID-19 based on your symptoms. You can also buy over-the-counter rapid tests at your local pharmacy or online, at your own cost. Having these on hand and using them when you feel symptoms may help you keep friends and family with weakened immune systems safe.

Where do I get the COVID-19 vaccine?

The COVID-19 vaccine is available at your pharmacy or doctor’s office. They are covered by your plan with no cost sharing when given by an in-network health care professional. Use our Find Care tool to see pharmacies and providers in your plan’s network. Most EmblemHealth members* can get the COVID-19 vaccine covered at participating pharmacies. A COVID-19 vaccination or booster is preventive care. You pay $0 if the only reason for your visit with an in-network doctor is to get the COVID-19 vaccine or booster.

*Medicare members with only EmblemHealth Part D (pharmacy) benefits cannot get the COVID-19 vaccine covered at an in-network pharmacy. Those members should contact their Part B carrier for coverage of the COVID-19 vaccine.

What treatments are available for COVID-19?

If you have COVID-19, speak to your doctor about the things you can do to help you recover. Depending on your health history, they may suggest over-the-counter fever reducers, cough medicine, or other ways to help manage your symptoms. If you need more help, your doctor may recommend an FDA-approved oral antiviral medicine to treat COVID-19, such as Paxlovid. If you experience an emergency, like trouble breathing, and need to go to the hospital, doctors may perform other treatments or procedures to help you get well. Services you get in an emergency room will be covered in an emergency.

Respiratory syncytial virus (RSV) vaccine

Respiratory syncytial virus (RSV) is a common virus that can cause cold-like symptoms. RSV infects the nose, throat, and lungs and spreads during the fall and winter. It can be dangerous to infants and older adults. 

How do I get tested for RSV?

Like other tests, your doctor can determine if you need to be tested for RSV based on your symptoms.

Where do I get the RSV vaccine?

The RSV vaccine is available for those meeting Centers for Disease Control and Prevention (CDC) guidelines. It’s best to get it in late summer or early fall. If you qualify, you can get it at:

Your doctor’s office: Just make an appointment. If the vaccine is the only reason for your office visit, it may be free of charge.*

If you received an RSV vaccine, you do not need another one. The CDC does not currently recommend this as an annual vaccine.

*Office visits are always free of charge for Medicaid/HARP or CHPlus, Medicare coverage varies based on plan. Medicare members should contact their Part B carrier for coverage of the RSV vaccine.

What treatments are available for RSV?

Most people with RSV get better by resting and managing their symptoms. But some people need more help. Speak to your doctor to find out what treatments may be available to you. If you experience an emergency, like trouble breathing, and need to go to the hospital, doctors may perform other treatments or procedures to help you get well.

Other Preventive Vaccines

Depending on your age or other conditions, your doctor may recommend other seasonal vaccines to keep you healthy.
happy senior couple holding grandchild and sitting on couch

Shingles Vaccine

Adults 50 years and older should get two doses of the shingles vaccine, separated by two to six months. Adults 19 years and older who have weakened immune systems should also get two doses of the shingles vaccine. Speak to your doctor to decide what’s right for you. 

Learn More
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Pneumonia Vaccine

The pneumococcal (pneumonia) vaccine protects against pneumonia and other types of infections caused by the most common strains of a bacterium called streptococcus pneumonia. It is recommended for adults over 50 years and children younger than 5 years, and for those who have certain chronic health conditions. 

Learn More

More Resources

It is important to make sure that you are getting your health information from reputable and reliable organizations. Be wary of claims made on social media or TV that are not supported by medical experts.

healthcare provider with patient in office

You can find reputable information about seasonal vaccines and viruses on official websites like the Centers for Disease Control and Prevention (CDC), county and city health departments, or your state’s health department.

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Also of Interest: 
HIP HMO Preferred Gold Plan   |   Protect Yourself and Your Community: Get Your Flu Vaccine   |   COVID-19, Flu, and RSV – What You Need To Know