COVID-19: 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.

No. Aetna members in Commercial and Medicaid plans will not have to pay any out-of-pocket costs for a COVID-19 vaccine, regardless of whether they go to an in-or out-of-network pharmacy or provider.

CMS pays for the cost of the vaccine for all Medicare beneficiaries. This includes, those in a Medicare Advantage plan, regardless of whether they go to an in-network or out-of-network pharmacy or provider. Please be sure to bring and show your red/white/blue Medicare ID card or your Medicare Number – not your Aetna member ID card – when you get vaccinated. This will help your health care provider or pharmacy to bill Medicare.

Yes, the booster is available at no cost to any eligible member either through insurance or a federal program for the uninsured.

Yes. Since a third dose of the Pfizer-BioNTech and Moderna vaccines is recommended by the CDC for individuals with weakened immune systems, the administration of a third mRNA COVID-19 vaccine is covered for those Aetna plan members.

For Medicare beneficiaries, including those in a Medicare Advantage plan, CMS will cover the cost for the third vaccine dose for those who qualify.

In accordance with the FDA and CDC guidelines, any individual whose immune system is compromised (such as those taking immune suppressant medication, undergoing chemotherapy or having recently received a transplant) qualifies for a third dose of an mRNA vaccine. Members should contact their health care provider with questions.

To determine if you are eligible for a third dosage, some vaccine administration sites may ask for an attestation or other documentation. If you are eligible, with Aetna medical and pharmacy insurance you won’t require a prescription for coverage of a third dose of an mRNA vaccine.

Yes. The FDA and CDC have now recommended that patients receiving the Johnson & Johnson (Janssen) vaccine receive a booster if the initial dose was received more than 2 months ago. The administration of this dose will be covered by Aetna.

If you are in one of the populations eligible for booster shots, it is recommended that you receive an additional dose to increase or "boost" your immune response to COVID-19. The effectiveness of the vaccines decreases over time and boosters restore immune response and reduce the risk of severe disease, hospitalization, and death. More information on booster shots is available from the CDC.

According to the FDA and CDC, eligible individuals may receive any COVID-19 vaccine as a booster shot. CDC’s recommendations now allow for this type of mix and match dosing for booster shots.

COVID-19 vaccinations are available at pharmacies as well as doctors’ offices at other clinical sites of care. The list of pharmacies participating with the federal government in the administration of the vaccine can be found on the CDC website. Additionally, VaccineFinder is a free, online service operated by Boston Children’s Hospital, in partnership with CDC, that has information on COVID-19 vaccine availability at certain providers and pharmacies in some states.

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.

You can also visit CVS.com for the latest updates on availability at CVS locations in your area.

Aetna follows the guidance provided by the CDC and FDA regarding the age of eligibility to receive the vaccine. Right now, children over the age of 12 are eligible to receive a standard dose of the Pfizer BioNTech vaccine. Children 5-11 are now eligible for a pediatric dose of the Pfizer BioNTech vaccine.

Children ages 5 to 11 and adolescents over age 12 can receive a Pfizer BioNTech vaccine through many of the vaccination locations already providing vaccines today, including pharmacies, health systems, and local vaccination clinics and events. Vaccine distribution strategies vary by state, so we encourage you to check your state’s vaccine website for more information. 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 where Pfizer BioNTech vaccines are available in your area.

The FDA has authorized three COVID-19 vaccines which have been shown to be safe and effective as determined by data from the manufacturers and findings from large clinical trials. These data demonstrate that the known and potential benefits of this vaccine outweigh the known and potential harms of becoming infected with COVID 19. CVS Health is only administering vaccines that have been authorized for use by the FDA and our COVID-19 vaccination services are being conducted in compliance with CDC guidance for safe delivery of 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 and it is recommended that individuals get both doses of the same vaccine.

Providers will need to ensure that individuals who got the first shot receive a second shot of the right vaccine at the right time.

Yes, the process will be very similar to receiving a flu vaccine, including scheduling an appointment with your vaccine provider. At CVS, you can walk in to receive a vaccine or schedule an appointment online at CVS.com or through the CVS app. CVS Pharmacy has ample experience in safely administering vaccines, including millions of flu shots every year.

Yes. As of September 2021, the CDC is strongly recommending that people who are pregnant or planning to become pregnant receive the COVID-19 vaccination. The CDC recommendations align with those from professional medical organizations serving people who are pregnant, including the American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine along with many other professional medical organizations. When unvaccinated pregnant people contract COVID-19, they may experience severe disease and higher rates of hospitalization, ICU admission and death than non-pregnant people. More information about COVID-19 vaccines while pregnant, breastfeeding or planning to become pregnant is available at the CDC COVID-19 Vaccines While Pregnant or Breastfeeding site.

The safety data shows no adverse complications in pregnancy related to the COVID-19 vaccination, including no association with having a miscarriage or impacts on fertility. More information about COVID-19 vaccines while pregnant, breastfeeding or planning to become pregnant is available at the CDC COVID-19 Vaccines While Pregnant or Breastfeeding.

The CDC now recommends that all adolescents ages 12 to 17 years should receive a booster shot 5 months after their primary series.

On August 12, the FDA authorized a third vaccine dose for certain immunocompromised individuals as part of its Emergency Use Authorization (EUA) amendment. The amendment applies to the Pfizer-BioNTech COVID-19 vaccine for patients 12 years and older and the Moderna COVID-19 vaccine for patients 18 years and older. Due to insufficient data, the EUA amendment for an additional dose does not apply to the Johnson & Johnson (Janssen) COVID-19 vaccine or to individuals who received the Johnson & Johnson (Janssen) COVID-19 vaccine as a primary series. The CDC and FDA are actively engaged to ensure that immunocompromised individuals who received the Johnson & Johnson (Janssen) COVID-19 vaccine have optimal vaccine protection and we expect to hear more guidance in the near future.