Member COVID-19 Information
What You Need to Know About COVID-19 and COVID-19 Vaccines
COVID-19 is a disease that affects breathing. It's caused by a new virus called a coronavirus, which can spread from person to person. People of all ages can get infected. Older adults and people with pre-existing medical conditions may be more likely to become gravely ill if infected. Medical conditions that include:
- chronic obstructive pulmonary disease,
- cancer,
- obesity,
- diabetes,
- and heart disease.
The number of cases continue to increase throughout the nation and around the world.
We all have a role to play to help protect our families and community from the spread of COVID-19. You can follow these tips to prevent getting the virus:
- Wear a mask.
- Stay six feet apart from others.
- Avoid crowds.
- Wash your hands often - at least 20 seconds each time.
- If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
- Get a flu vaccine.
A COVID-19 vaccine gives you the best chance of protecting yourself and your loved ones from getting COVID-19 symptoms and health problems in the future. All authorized vaccines at this time are given in two doses with a few weeks between each shot. After your first shot, you will get a card that reminds you not to forget your second shot. It's important to get both doses of the same vaccine.
California is giving the vaccine to different groups of people in a phased approach.
As of February 2021, COVID-19 vaccines will be dispensed as follows:
PHASE 1A: Now Vaccinating
- Health care workers
- Long-term care residents
PHASE 1B: Now Vaccinating as supplies allow
- People 65 and older
- Sector groups:
- Education and childcare
- Emergency services
- Food and farming
Starting in March as supplies allow
- People with severe disability and those with health conditions that put them at high risk
Other groups should have access to the vaccines later in 2021.
You can sign up or call (833) 422-4255 (M-F 8 a.m. to 8 p.m., Sat-Sun 8 a.m. to 5 p.m.) to see if it's your turn to get the COVID-19 vaccine. If you are not listed to get the vaccine at this time, you can sign up to get an alert when it's your turn. Visit Vaccinate All 58 for the latest information on vaccine phases in California.
We all have a role to play to help keep our families and community safe from the spread of COVID-19. Follow these tips to help prevent yourself and others from getting sick:
- Wear a mask.
- Stay six feet apart from others.
- Avoid crowds.
- Wash your hands often - at least 20 seconds each time.
- If soap and water are not available, using a hand sanitizer with at least 60% alcohol.
- Get a flu vaccine.
There will be a short supply of vaccine at first, but California expects supplies to increase over time. Check these options to find a vaccination site when you are able to get the vaccine:
- Contact your doctor or pharmacist.
- Reach out to your county public health department.
- Visit https://myturn.ca.gov or call (833) 422-4255 (M-F 8 a.m. to 8 p.m., Sat-Sun 8 a.m. to 5 p.m.)
- Check www.vaccinateca.com
The safety of the COVID-19 vaccine is the main focus! The U.S. Food and Drug Administration (FDA) takes care to review all safety data from clinical trials. They then approve emergency vaccine use only when the expected benefits outweigh potential risks. Scientists tested COVID-19 vaccines across many diverse backgrounds. This helped to ensure the vaccines meet safety standards.
After a vaccine is authorized for use through the EUA, scientists and health professionals will keep tracking its use. Health care providers are required to report certain adverse events after vaccination to the Vaccine Adverse Event Reporting System (VAERS). When you receive your vaccine, you will also receive an information sheet. The sheet lets you know how to enroll in a program called v-safe. V-safe allows you to report problems or adverse reactions you have after getting a COVID-19 vaccine. Your report will go to the Centers for Disease Control (CDC). Plus, the FDA and CDC will keep tracking the safety of COVID-19 vaccines. They want to make sure that even very rare side effects are found as early as can be.
V-safe is a smartphone-based tool. It uses texts and web surveys to provide customized health check-ins after you receive a COVID-19 vaccination. Visit V-safe to register! Through v-safe, you can quickly tell the CDC if you have any side effects after getting your COVID-19 vaccine. As a result of how you answered, someone from the CDC may call to check on you and get more information. V-safe will also remind you to get your second COVID-19 vaccine dose if you need one.
You may have soreness, swelling and redness around the point of where the shot was given. You could also develop fatigue, headache, body aches, chills or fever. Some people have nausea, vomiting or diarrhea. These reactions are normal. The side effects occur as your body begins to build immunity to help fight off future COVID-19 exposures.It is important to know that you cannot get COVID-19 from the vaccine. The vaccines in use today and the others that are being made do not contain a live virus.
COVID-19 vaccines are being tested in large clinical trials to assess their safety. But it does take time, and more people will need to get a vaccine before we learn about any rare or long-term side effects. That is why safety tracking will continue. The CDC has a separate group of experts that reviews all the safety data. And, they provide regular safety updates. If a safety issue is found, quick action will be taken to see if the issue is linked to the COVID-19 vaccine. Also, steps will be taken to plot the best course of action.
Moderna and Pfizer/BioNTech vaccines are 94-95% effective in keeping people from developing COVID-19 symptoms.
Yes. Pfizer/BioNTech and Moderna's COVID-19 vaccines have some effect against some strains of SARS-CoV-2 found in the UK (B.1.1.7) and South Africa (B.1.351) to date.
No. But getting your COVID-19 vaccine will give you the best chance to protect yourself and your loved ones from getting COVID-19 symptoms. It can also help prevent any COVID-19 health problems in the future.
All authorized COVID 19 vaccines are safe and effective. Due to short vaccine supplies, it is best to get the vaccine that is available to you. If the vaccine requires two doses, make sure that your second dose matches the vaccine you received during your first dose.
Even if you have had COVID-19, you should still get the vaccine. There's a chance you can contract COVID-19 more than once, so getting the vaccine is a safe choice.
It takes time for the body to build immunity after any vaccination. The Pfizer/BioNTech and Moderna COVID-19 vaccines require two doses. They provide the best protection one-to-two weeks after the second dose. Getting a COVID-19 vaccine will offer natural immunity. But, as of now, scientists do not know how long this protection will last.
No. The vaccine will not cause you to test positive for COVID-19. It may cause you to test positive for antibody tests. This is because the vaccine helps build antibodies to the virus.
Having an allergy to food or medicines does not mean you are at a higher risk of having an allergic reaction to the COVID-19 vaccine. Both the Pfizer/BioNTech and Moderna vaccines do not contain eggs, preservatives, or latex. Consult your doctor before getting a vaccine if you have severe allergies. If you have been told to carry an epinephrine auto-injector for any reason, continue to do so - most notably when you get a vaccine. The CDC suggests a period of 15 minutes for everyone getting a vaccine to be observed. This 15-minute period increases to 30 minutes for those with a history of having allergic reactions.
A few groups should not get the vaccine, and some others should consult with their doctor.
People who should not get the COVID-19 vaccine include:
- People with a severe allergy to an mRNA vaccine component.
- Those younger than 16 years of age (as of today vaccines are authorized only for ages 16 and older).
- People that are isolating or are having symptoms of COVID-19. These people can get a vaccine after they have finished isolation and their symptoms have gone down.
People who may get the vaccine after thinking about the risks, benefits and talking with their doctor include:
- People with a history of severe allergy to any vaccine or injected medication.
- People who are pregnant.
- People who breastfeed.
- People on blood-thinning medication.
The American College of Obstetricians and Gynecologists suggests that the COVID-19 vaccine be offered to people who are pregnant or breastfeeding. It does not require people of childbearing age to have a pregnancy test before getting the vaccine. Please consult with your doctor to see if the COVID-19 vaccine is best for you.
Can my child get the vaccine?
As of right now, the Pfizer-BioNTech vaccine is suggested for people ages 16 and older. The Moderna vaccine is suggested for those ages 18 and older.
When I get the vaccine, can I stop wearing a mask or social distancing?
No. It will take time for your body to build immunity after the vaccine. To prevent yourself from getting sick it's important to:
- Social distance
- Wear a mask in public
- Avoid crowds
- Wash hands often - at least 20 seconds each time.
No. The COVID-19 vaccine should be given 14 days before or after other vaccines. At this time there is limited information on the safety of getting other vaccines at the same time as the COVID-19 vaccine.
The Pfizer/BioNTech and Moderna clinical trials were not designed to test the effect of a single dose. People involved in the studies all received two doses. It is best to get two doses to achieve the best result.
If you miss your second dose appointment at 21 days (for Pfizer/BioNTech vaccine) or 28 days (for Moderna vaccine), it is OK. Those dates are the earliest you can get the second dose. It is important to get your second dose as close to those dates to get the full strength of the vaccine.
The second dose of Pfizer/BioNTech and Moderna COVID-19 vaccines may be scheduled up to six weeks (42 days) after the first dose. There is a small amount of data on how well the vaccines work when given after that time.
Herd Immunity is a term used to describe when enough people within a large group have protection-either from previous infection or vaccination. The desired result is that the disease spread slows and, in time, stops. Once achieved, everyone within that group is protected, even if some people don't have any protection themselves.
A COVID-19 Vaccination Record Card is a small and handy paper card that will be given to you when you receive your first COVID-19 vaccine. This will help you keep track of when you received your first dose and when you should get your second dose. It's an easy way to help you keep track of your vaccines.
If the vaccine requires two doses, people should get the same vaccine for both doses in two different visits. Call the health center or provider you received your first dose from to ask about your vaccine information. Be sure to confirm your second appointment and the place to get it.
The provider should have scheduled a second appointment with you at the same place when you received the first dose. But, you can get your second dose from another provider/place. You'll need to show your COVID-19 Vaccination Record Card so the provider knows what vaccine you have received.
No. The COVID-19 vaccine will be at no cost to you. You do not need to get a prior approval for your vaccine. You may be asked to provide your health insurance information for tracking data.
- No, you are able to receive COVID-19 vaccination without a doctor's script or referral at any pharmacy.Follow your health plan's guidelines for where to get other non-COVID-19 vaccines.
- You can also visit a different place for your second dose, if needed.
- You can receive your vaccinations at any place. This includes mass vaccination centers, if/when they are open.
- There is no cost to get the vaccine at a pharmacy.
- The pharmacy will bill the vaccine administration fee straight to the health plan.
- You may be asked to provide your health insurance information.
The provider should have scheduled a second appointment with you at the same place when you received the first dose. But, you can get your second dose from another provider/place. You'll need to show your COVID-19 Vaccination Record Card so the provider knows what vaccine you have received.
The US Food and Drug Administration (FDA) authorized the Pfizer/BioNTech COVID-19 vaccine for emergency use to prevent COVID-19 in ages 16 years and older on 12/11/2020. The Moderna COVID-19 vaccine was granted FDA approval on 12/18/2020 for use in people18 years of age and older.
When it's your turn to get the vaccine, check these options to find where to get the vaccine:
- Contact your doctor or pharmacist.
- Reach out to your county public health department.
- Visit https://myturn.ca.gov or call call (833) 422-4255 (M-F 8 a.m. to 8 p.m., Sat-Sun 8 a.m. to 5 p.m.)
- Check www.vaccinateca.com.
COVID-19 Testing
You can receive covered services when ordered, referred and/or performed in the In-Network places listed below:
- Physician's/Practitioner's Office
- Independent Laboratory/Diagnostic Facility
- Urgent Care Center
- Emergency Department
Services include:
- Medically-required COVID-19 diagnostic testing.
- Medical screenings and/or treatment.
- Related doctor's visit.
Unsure if you have been exposed to or are at-risk of having COVID-19? Schedule a visit with a telehealth provider. It's a good option for non-urgent care.
Some people can have COVID-19 and be contagious without showing symptoms. People with COVID-19 symptoms have mild to severe breathing problems. Other symptoms include:
- fever or chills
- cough
- shortness of breath
- fatigue
- body aches
- headache
- new loss of taste or smell
- sore throat
- congestion or runny nose
- nausea or vomiting
- diarrhea
Influenza (the flu) is another illness that affects breathing. It's caused by flu viruses (Type A and Type B). The flu is highly active in the United States during the winter months. Everyone six months of age and older should get a flu vaccine.
If you have been exposed or begin showing symptoms of COVID-19 or the flu, contact your health care provider or health department right away.
COVID-19 Testing/Screening Cost-Shares and Prior Authorizations
With your Medicare Advantage plan, we are waiving your costs for the following care:
- COVID-19 treatment from April 1, 2020 through May 31, 2021, including inpatient and outpatient services. Starting on June 1, 2021, your usual plan cost shares will apply.
- COVID-19 diagnostic tests, including serology or antibody tests, and visits to get the test, for the duration of the public emergency.
- COVID-19 screening related tests (e.g., influenza tests, blood tests, etc.) performed during a provider visit that results in an order for, or administration of, diagnostic testing for COVID-19. This is also for the duration of the public emergency.
- COVID-19 Vaccine with no prior authorization required.
- Virtual care until May 31, 2021. Starting on June 1, 2021, your usual plan cost shares will apply.
No. We will cover medically-required COVID-19 testing and medical screenings at no charge to you. We will do this when these services are ordered and/or referred by a licensed health care provider. If relevant, your plan will waive the costs for required COVID-19 diagnostic testing along with the doctor visit. This includes:
- copayment
- coinsurance
- deductible cost-sharing
Yes. Any medically-required treatment linked to COVID-19 would be a covered benefit for all:
- Medicare,
- Cal MediConnect,
- Medi-Cal,
- Commercial fully-insured members
We are committed to making sure you have access to COVID-19 treatment services per federal and state law.
No. We will not require prior authorization, prior certification, prior notification and/or step therapy protocols for medically necessary COVID-19 diagnostic testing & medical screening services, when medically necessary services are ordered and/or referred by a licensed health care provider.
Pharmacy and Prescriptions - Refills and Emergency Supply
Yes, you will be able to refill your prescriptions prior to the refill date.
Access to Care and Vulnerable Individuals
Call Access 2 Care at 1-866-653-0975to schedule a ride to and from the vaccine appointment. Remember you are required to call 48 hours in advance of the appointment. Access 2 Care does provide free translations, however you maycontact WellCare customer service to assist with booking at 1-866-999-3945.
You may be able to get transportation help by contacting United Way-211 to access local transportation resources. This may include the Lyft Vaccine Alliance Program.
Mental Health and Coping Assistance
Worry and stress can rise about the spread of COVID-19. Concern for friends and family who live in places where COVID-19 cases are growing is natural. So is concern about the continued spread of the disease. Try these tips to help you cope:
- Take care of your body. Take deep breaths, stretch or meditate.
- Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships and a sense of hope and positive thinking.
- Share the facts about COVID-19 and the real risk to others. People who have returned from places of ongoing spread for more than 14 days, and do not have symptoms of COVID-19, have a much lower chance of putting others at risk. Wearing masks, washing hands and social distancing help to keep the risk very low.
For more information, see the CDC's suggestions for mental health and coping during COVID-19.