COVID-19 Updates
Update as of September 16, 2023
Flu shots for the 2023-2024 Flu Season and the Updated Covid-19 vaccine are now available for $0 cost share to members.
These vaccines may be obtained at a pharmacy or provider office.
| 2023-2024 Pfizer-BioNTech and Moderna COVID-19 vaccines formulations for ages 6 months to 11 years | |
| NDC | Product Name |
| 59267433101 | PFIZER COVID 2023-24(5-11Y)EUA |
| 59267433102 | PFIZER COVID 2023-24(5-11Y)EUA |
| 59267431501 | PFIZER COVID 2023-24(6M-4Y)EUA |
| 59267431502 | PFIZER COVID 2023-24(6M-4Y)EUA |
| 80777028792 | MODERNA COVID 23-24(6M-11Y)EUA |
| 80777028707 | MODERNA COVID 23-24(6M-11Y)EUA |
| 2023-2024 Pfizer-BioNTech and Moderna COVID-19 vaccines for ages 12 years and older | |
| NDC | Product Name |
| 00069236201 | COMIRNATY 2023-24(12Y UP) VIAL |
| 00069236210 | COMIRNATY 2023-24(12Y UP) VIAL |
| 00069239201 | COMIRNATY 2023-24(12Y UP) SYRG |
| 00069239210 | COMIRNATY 2023-24(12Y UP) SYRG |
| 80777010201 | SPIKEVAX 2023-24 (12Y UP) SYRG |
| 80777010204 | SPIKEVAX 2023-24 (12Y UP) VIAL |
| 80777010293 | SPIKEVAX 2023-24 (12Y UP) SYRG |
| 80777010295 | SPIKEVAX 2023-24 (12Y UP) VIAL |
| 80777010296 | SPIKEVAX 2023-24 (12Y UP) SYRG |
Update as of October 7, 2023 Novavax Covid-19 Vaccine is also available at $0 Cost share to members
| 2023-2024 Novavax Covid-19 Vaccine for ages 12 and older | |
| NDC | Product Name |
| 80631010501 | NOVAVAX COVID 2023-24 VL (EUA) |
| 80631010502 | NOVAVAX COVID 2023-24 VL (EUA) |
The COVID-19 Public Health Emergency (PHE) will expire Thursday, May 11, 2023, according to an announcement from the Biden Administration.
Starting on May 12, 2023 over-the-counter (OTC) Covid-19 test kits will no longer be covered at $0 cost share. On May 12, 2023 test kits will be subject to the retail or market price and will no longer process as a claim under the pharmacy benefit. Members will be responsible for the full retail price when purchasing OTC Covid-19 test kits.
COVID-19 Testing: Starting June 1, 2023 Covid-19 testing and related office visits will no longer be covered at $0 cost share. On June 1, 2023 testing and office visit will be subject to the member’s plan benefits and member will be responsible for all related cost share amounts. Covid-19 vaccines will be covered under the member’s preventive benefit with $0 member cost share
