As the COVID-19 vaccine becomes widely available, we are here to help answer your questions about cost, availability and coverage.
Member Frequently Asked Questions
How much will the vaccine cost?
- If submitted to MaxorPlus, you will pay $0 to receive your vaccine.
Where and when can I receive the vaccine using MaxorPlus coverage?
- MaxorPlus will accept claims from any contracted pharmacy for the COVID-19 vaccine. No network restrictions apply.
- Call ahead to local pharmacies to make sure they have available vaccines. Large retail pharmacy chains administering the vaccine currently are CVS, Walgreens and Walmart. Other pharmacies in your area may also be able to administer the vaccine.
What if the vaccine is not covered by my pharmacy benefit?
You will pay $0 for the COVID-19 vaccine, regardless of your pharmacy benefit plan’s design.
How is the vaccine administered?
- Currently, two vaccines are authorized by the FDA:
- Pfizer Vaccine: 2 doses (second dose 21 days after first dose)
- Moderna Vaccine: 2 doses (second dose 28 days after first dose)
Client/Plan Frequently Asked Questions
How much will the vaccine cost to plans?
- The cost of the COVID 19 vaccine itself is being paid for by the US Government while the administration fees will be covered by Plan Sponsors.
- The initial vaccines will require two doses. The administration fee for the first dose will be approximately $17, and the second dose’s administration fee will be approximately $28.
- Members will pay $0 cost sharing, regardless of their plan design..
Who is currently eligible to get the vaccine?
- COVID-19 vaccines are being allocated to First Responders, residents of Long Term Care facilities and other at-risk groups.
- After these groups are vaccinated, it will be more readily available to the general population.
What will the MaxorPlus plan cover?
- All plans are configured in the adjudication system to allow for members to receive the COVID-19 vaccines at $0 cost share.
- MaxorPlus will accept claims from any contracted pharmacy for COVID-19 vaccines.
- MaxorPlus will not be restricting the network for this vaccine.