Yearly Preventive
Vaccines

Female is getting vaccine at doctor's office.

Getting a flu or COVID-19 vaccine each year is an important thing
you can do to protect yourself, your family, and your community.

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 flu complications. 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. 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 seasonal vaccines, such as the 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.

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

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 including Duane Reade, Walgreens, and Rite Aid. 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.

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 to see what is covered. You may have to pay your copays, coinsurance, and/or deductibles according to your plan’s benefits.

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 who are immunocompromised safe.

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. Most EmblemHealth members* can get the COVID-19 vaccine covered at participating pharmacies including Duane Reade, Walgreens, and Rite Aid. 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 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.

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 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.

Other Seasonal Vaccines

Depending on your age or other conditions, your doctor may recommend other seasonal vaccines to keep you healthy.

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

Always ask your doctor before you try a new treatment or procedure to help you get well. Being sick can be hard and troubling, but following your doctor’s orders will help you get well and get back to your life.

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