Flu; Pneumonia; Tetanus, Diphtheria and Pertussis (Tdap); Tetanus and Diphtheria (Td); Shingles; and Meningococcal Vaccines
Date Issued: 01/29/2019
Flu Vaccines Available
Originally Issued: 5/13/2014 | Updated 01/29/2019
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 (the set dollar amount you pay for health services each time you use them), deductible (the amount you pay before your plan starts to pay), or coinsurance (the percentage you pay at each visit once you have met your deductible).
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.
To find a nearby location that participates in the EmblemHealth vaccine program:
- Search for an EmblemHealth network pharmacy by clicking on the “Find a Pharmacy” link.
- Call our Flu Information Line at 877-859-9001 (TTY: 711). Our hours are 8 a.m. to 8 p.m., Monday to Friday.
- Call Customer Service at the phone number listed on the back of your member ID card.
Contact your network pharmacy ahead of time to make sure the vaccine is available, learn about any age restrictions, and find out the times they are giving vaccines. 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 reading Flu Facts: Frequently Asked Questions.
Are any other vaccines for older adults available at local pharmacies?
In addition to 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 (whooping cough). Every adult should get the Tdap vaccine once if they did not receive it as an adolescent to protect against pertussis, 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). The shingles vaccine is recommended for all adults 50 years of age and older. There are two shingles vaccines available: Shingrix and Zostavax. The Centers for Disease Control and Prevention (CDC) recommends that healthy adults ages 50 years and older receive two doses of Shingrix, which is the preferred vaccine. Zostavax requires only one dose and may be used in healthy adults ages 60 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?
Ask your doctor or pharmacist if you should receive any of these vaccines. You can also find out more by reviewing the following information from the Centers for Disease Control and Prevention (CDC):