Vaccine FAQs

No. Aetna members in Commercial and Medicaid plans will not have to pay any out-of-pocket costs for a COVID-19 vaccine. For Medicare beneficiaries, CMS will cover the full cost of the vaccine, including those in a Medicare Advantage plan.

Yes, Aetna will cover COVID-19 vaccine administration fees without cost-sharing, for both in- and out-of-network providers, for Commercial and Medicaid members.

CMS has indicated it will pay for the cost of the vaccine for all Medicare beneficiaries, including those in a Medicare Advantage plan.

Aetna will cover any COVID-19 vaccine that has received FDA authorization, at no added cost to members. 

To date, the FDA has issued Emergency Use Authorizations for the Pfizer-BioNTech and Moderna COVID-19 vaccines.

Both the Pfizer-BioNTech and Moderna vaccines have two doses, with the second dose coming a few weeks after the first. Pfizer-BioNTech’s second dose comes three weeks after the first, and Moderna’s comes four weeks later. The second dose gives people a strong, long-lasting immunity. While the two leading vaccines include a second dose, some future vaccine candidates may only require one dose. Johnson & Johnson, for example, is expecting data in January that will show whether its experimental vaccine works after a single dose. In case it doesn’t, the company has also started a separate trial using two doses.

CMS has provided additional guidance to plans, states and providers to ensure that the statutory requirements related to COVID-19 vaccination and coverage of administration costs are implemented as Congress intended. CMS issued the following payment allowances and related information for administering COVID-19 vaccines during the Public Health Emergency:

 COVID-19 vaccine administration reimbursement rates:

• 0001A - (Pfizer Admin): ADM SARSCOV2 30MCG/0.3ML 1ST - Rate: $16.94
• 0002A - (Pfizer Admin): ADM SARSCOV2 30MCG/0.3ML 2ND - Rate: $28.39
• 0011A - (Moderna Admin): ADM SARSCOV2 100MCG/0.5ML1ST - Rate: $16.94
• 0012A - (Moderna Admin): ADM SARSCOV2 100MCG/0.5ML2ND - Rate: $28.39
• 0021A - (AstraZeneca): ADM SARSCOV2 5X10^10VP/.5ML 1 - Rate: $16.94
• 0022A - (AstraZeneca): ADM SARSCOV2 5X10^10VP/.5ML 2 - Rate $28.39
• 0031A - (Janssen): ADM SARSCOV2 VAC AD26 .5ML - Rate $28.39

Per guidance provided by CMS, Medicare beneficiaries enrolled in MA plans will be able to access the COVID-19 vaccine, without cost sharing, at any Fee for Service provider or supplier participating in Medicare and eligible to bill under Part B for vaccine administration, including those enrolled in Medicare as a mass immunizer or a physician, non-physician practitioner, hospital, clinic or group practice. Providers should submit claims for administration of the COVID-19 vaccine to the CMS Medicare Administrative Contractor (MAC) for payment.

COVID-19 vaccinations will be available at pharmacies as well as doctors’ offices at other clinical sites of care. The initial list of pharmacies participating with the federal government in the administration of the vaccine can be found here.

Our State Resource lookup tool provides links to each state’s health department and vaccine resource page, so you can get the latest information about when and where vaccines will be available in your area.

CVS is currently working with several states to help vaccinate their priority populations, including health care workers, frontline essential workers, and seniors, in a small number of CVS Pharmacy locations. Please visit CVS.com for the latest updates on availability at CVS locations in your area. Timing and eligibility will vary from state to state, based on state guidelines.