What you need to know about COVID-19

 

Coronavirus Disease 2019 (COVID-19) is a new disease that causes respiratory illness in people and can spread from person to person.

People of all ages can be infected. Older adults and people with pre-existing medical conditions like asthma, diabetes and heart disease may be more likely to become severely ill if infected.

For more information, please follow our COVID-19 FAQ resources below or visit health.ny.gov

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NYSDOH Fact Sheet

COVID-19 Vaccines, Tests, Treatment, Boosters and You
➥ NYS Medicaid

COVID-19 Vaccines

These FAQs provide answers to some of the most frequently asked questions on COVID-19 vaccines.

What is the COVID-19 vaccine?

There is now a vaccination available that will give you the best chance of protecting yourself and your loved ones from getting COVID-19 in the future. Some COVID-19 vaccines will have two doses a few weeks in between each shot. 

You will get a COVID-19 Vaccination Reminder Card that will help you keep track of which vaccine you receive and when to get a second dose, if needed. If you receive a vaccine that requires two doses, it is important to get both doses.

Where can I get the COVID-19 vaccine?

The vaccine is being administered to different populations in a tiered approach.  When you are able to get the vaccine, call your doctor with any questions and ask when you can make an appointment with them or at your local pharmacy.  Or, find out where to get your vaccine at cdc.gov/coronavirus/2019-ncov/vaccines or vaccinefinder.org.

Am I required to get my COVID-19 vaccine?
While it is not a requirement, getting your COVID-19 vaccine will give you the best chance of protecting yourself and your loved ones from getting COVID-19 in the future.
I already had COVID-19. Should I still get the vaccine?
Even if you have already had COVID-19, you should still get the vaccine. It may be possible to be infected more than once so getting the vaccine is a safe choice.
Can my child get the vaccine?

CDC recommends COVID-19 vaccines for everyone 6 months and older and boosters for everyone 5 years and older, if eligible.

When I get the vaccine, can I stop wearing a mask or social distancing?

Fully vaccinated is considered two weeks past final dose, meaning the second dose of the Moderna or Pfizer mRNA vaccine, or, two weeks past the single dose Johnson & Johnson vaccine.

To maximize protection from COVID-19 and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial of high transmission.

Wearing a mask is most important if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated. If this applies to you or your household, you might choose to wear a mask regardless of the level of transmission in your area.

Fully vaccinated people who have come into close contact with someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.

Is the vaccine safe?
The safety of the COVID-19 vaccine is a top priority! The Food and Drug Administration (FDA) carefully reviews all safety data from clinical trials and authorizes emergency vaccine use only when the expected benefits outweigh potential risks. COVID-19 vaccines were tested in large clinical trials to make sure they meet safety standards.
Will there be any side effects when I get the vaccine?
You may run a fever after you get the vaccine. This is normal as your body builds immunity and fights off future COVID-19 exposures. You may feel sick after getting vaccinated. You could develop:
  • Fever
  • Headaches
  • Body aches

This is your body reacting to the vaccine. It is a normal response. It is important to know that it is impossible to get COVID-19 from the vaccine. The vaccines currently in use and others being developed do not contain a live virus. 

Do I have to pay for my vaccine? Or get prior authorization?

No. The COVID-19 vaccine will be at no cost to you. You do not need to get a prior authorization for your vaccine.

I lost my COVID-19 Vaccination Record Card. What should I do now?
Please call the administering facility/provider you received your first dose from to ask about your vaccine information and verify your second appointment/location.
I am due for my second dose. I got my first dose from another provider who is not my PCP, what do I do now?
The provider should have scheduled a second appointment with you at the same facility when you received the first dose. However, you can receive your second dose from another provider/facility and you should present your COVID-19 Vaccination Record Card.
I’m pregnant. Should I still get the COVID-19 vaccine?

According to the CDC, people who are pregnant and part of a group to receive the COVID-19 vaccine may choose to be vaccinated. If you have questions about getting the vaccine, it is recommended to discuss with your doctor to make an informed decision.

Am I eligible for a booster?

Eligible for 1 booster:

  • Everyone ages 5 years and older can get 1 boosterafter completing their 

COVID-19 vaccine primary series.


Eligible for 2 boosters:

  • Adults ages 50 years andolder
  • People ages 12 years and older who are moderately or severely immunocompromised
  • People who got 2 doses (1primary dose and 1 booster) of Johnson & Johnson’s Janssen vaccine

When I get the vaccine, can I stop wearing a mask or social distancing?

Fully vaccinated is considered two weeks past final dose, meaning the second dose of the Moderna or Pfizer mRNA vaccine, or, two weeks past the single dose Johnson & Johnson vaccine.

To maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial of high transmission.

Wearing a mask is most important if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated. If this applies to you or your household, you might choose to wear a mask regardless of the level of transmission in your area.

Fully vaccinated people who have come into close contact with someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.

What do we know about breakthrough cases for those fully vaccinated?

A small percentage of people who are fully vaccinated will still get COVID-19 if they are exposed to the virus that causes it. These are called “vaccine breakthrough cases.” This means that while people who have been vaccinated are much less likely to get sick, it will still happen in some cases. It’s also possible that some fully vaccinated people might have infections, but not have symptoms (asymptomatic infections). Experts continue to study how common these cases are.

If you get COVID-19 after vaccination, your symptoms might be less severe

Fully vaccinated people are much less likely to be hospitalized or die than people with similar risk factors who are not vaccinated.

Coronavirus (COVID-19) FAQs

Get answers to common questions about symptoms, diagnosis, risk, prevention, testing, and treatment for COVID-19.
What is COVID-19?

COVID-19 is a respiratory disease and a type of virus called a coronavirus. It has become a public health emergency. 

What are the symptoms of COVID-19?
The symptoms of Coronavirus (COVID-19) include:
  • Mild to severe respiratory symptoms
  • Fever
  • Cough
  • Shortness of breath
  • Lower respiratory illness

COVID-19 can be contagious before a person begins showing symptoms.

Where do I go if I have symptoms?

Contact your provider if you develop a fever, have a cough, or have difficulty breathing. Let your provider know if you’ve been in close contact with a person known to have Coronavirus.

For additional information, you can also contact The New York State Department of Health toll-free Novel Coronavirus Hotline at 1-888-364-3065.

If exposed, what should I do?

• If you think you have COVID-19 or have been exposed to someone who has been diagnosed with COVID-19, call your provider’s office or contact Teladoc for guidance on next steps.

• Call ahead before going in person to any doctor’s office.

• Don’t go to your local emergency room for COVID-19 testing. The ER is only for those who need the most critical care.

Members who have questions about their telehealth benefit should call Member Services at 1-888-FIDELIS (1-888-343-3547); TTY: 711.

How do I protect myself and my community?

We all have a role to play in protecting our communities and families from the spread of Coronavirus. It is similar to other communicable viruses. You can also follow these tips to prevent infection:

  • Stay home when you are sick.
  • Avoid close contact with people who are sick.
  • If you are sick, you should wear a facemask when around other people.
  • Wash your hands thoroughly and frequently. Use soap and water for at least 20 seconds.
  • Use an alcohol-based hand sanitizing rub (must contain at least 60 percent alcohol).
  • Cover your mouth when you cough or sneeze by coughing/sneezing into your elbow.
  • Wear a face covering/mask when in public and/or around others who do not live in your home if you are not fully vaccinated
  • Clean public surfaces thoroughly.
  • Avoid shaking hands.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
How do I cope with the outbreak?

Worry and anxiety can rise about the spread of COVID-19. Concern for friends and family who live in places where the spread of COVID-19 is progressing is natural. Some recommendations to help manage your feelings include the following:

  • 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, a sense of hope and positive thinking and use technology to stay connected.
  • Share the facts about COVID-19 and the actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.
  • For more information, see the CDC’s suggestions for mental health and coping during COVID-19.
What else causes similar symptoms to COVID-19?
Influenza (the flu), acontagious respiratory illness caused by the influenza viruses (Type A and TypeB), has high activity in the United States at this time. Everyone 6 months ofage and older should get a flu vaccine.
Is prior authorization required for COVID-19 testing and screening services under my plan coverage?

No. We will not require prior authorization, prior certification, prior notification and/or step therapy protocols for medically necessary COVID-19 diagnostic testing and medical screening services when ordered and/or referred by a licensed health care provider.

Where may I receive COVID-19 testing/screening/treatment services under my plan coverage?

Medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment and the associated physician’s visit will be covered when ordered, referred and/or performed in the following In-Network locations:

  • Physician’s/Practitioner’s Office
  • Independent Laboratory/Diagnostic Facility   
  • Urgent Care Facility
  • Emergency Department Facility

Are you unsure if you have been exposed to or at-risk of being infected with COVID-19? Schedule a virtual care visit with a provider. It is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility.  

Will I be responsible for any out-of-pocket costs for COVID-19 testing & screening services?

We will cover medically necessary COVID-19 diagnostic testing and medical screening services, when such services are ordered and/or referred by a licensed health care provider. Depending on your plan, your copayment, coinsurance and/or deductible cost-sharing may be waived for medically necessary COVID-19 diagnostic testing and medical screening services.

If I need treatment for coronavirus, is that covered by my plan?

Any medically necessary treatment related to COVID-19 would be considered a covered benefit.  We are committed to ensuring access to COVID-19 treatment services in accordance with federal and state law.

Does my plan cover COVID-19 testing/screening/treatment services?

Yes. When medically necessary diagnostic testing, medical screening services and/or treatment is ordered and/or referred by a licensed health care provider, we will cover the cost of medically necessary COVID-19 tests, and screenings.

Are there strategies for coping with the COVID-19 outbreak?

Worry and anxiety can rise about the spread of COVID-19. Concern for friends and family who live in places where COVID-19 is spreading or the progression of the disease is natural.

  • 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 actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.

Can I get help with transportation?

You may be able to receive transportation by contacting United Way-211 to access local community resources for transportation, which may include the Lyft Vaccine Alliance Program.

In addition, Lyft and Uber offer free rides to anyone going to a vaccination site to get vaccinated. Using the Lyft or Uber app, you can select a vaccination site near you and follow simple directions to redeem your ride. The ride will take you to and from a nearby vaccination site free of charge. The feature will run until July 

What do we know about the Delta variant?

The Delta variant is highly contagious, nearly twice as contagious as previous variants.

  • Some data suggest the Delta variant might cause more severe illness than previous strains in unvaccinated persons
  • Unvaccinated people remain at the greatest risk for severe illness, hospitalization, and death
  • Fully vaccinated people with Delta variant breakthrough infections can spread the virus to others. However, vaccinated people appear to be infectious for a shorter period of time
  • Vaccines are highly effective, including against the Delta variant.

COVID-19 At-Home Tests

These FAQs provide answers to questions about the reimbursement of COVID-19 at-home tests.

For Medicaid, Child Health Plus, and HARP members

For Qualified Health Plan and Essential Plan members

If I go to the pharmacy, can I get a COVID-19 test for free?

Yes. COVID-19 tests are available at no cost to Fidelis Care Medicaid Managed Care, Child Health Plus (CHP), HealthierLife – Health and Recovery Plan (HARP), Qualified Health Plan and Essential Plan members if you go to an in-network pharmacy. You do not need a prescription from your doctor. Test Kits eligible for coverage can be found by clicking here.

I went to an in-network pharmacy, however, they said I have to pay out of my pocket. What do I do?

Fidelis Care is currently working with our pharmacy partners to ensure COVID-19 tests are available at no cost if you go to an in-network pharmacy. If you purchased an at-home COVID-19 test at the pharmacy, we will reimburse you for the cost of the test after you complete the member reimbursement process. The reimbursement will be limited up to the amount set by New York Medicaid or federal guidance (up to $24, per test Kit, per covered individual).  At-Home COVID-19 tests are packaged in sets of two tests in a single box. The single box is also referred to as a “Kit.”

What if I bought a COVID-19 test on my own, will I be reimbursed?

Yes, if you purchased an at-home COVID-19 test at a pharmacy, we will reimburse you for the cost of the test after you complete the member reimbursement process. Reimbursement will require proof of purchase and is subject to the benefit’s four test Kits per month coverage limit. The reimbursement will be limited up to the amount set in New York Medicaid or federal guidance (up to $24, per test Kit, per covered individual).  At-Home COVID-19 tests are packaged in sets of two tests in a single box. The single box is also referred to as a “Kit.”

Is there a limit to the number of tests that I may obtain for free?

Yes, we will cover four (4) At-Home COVID-19 test Kits (8 tests), obtained over-the-counter, per covered individual in a 30-day period, consistent with New York Medicaid or federal guidance.

If I go to the pharmacy, can I get a COVID-19 test for free?

Yes. COVID-19 tests are available at no cost to Fidelis Care Medicaid Managed Care, Child Health Plus (CHP), HealthierLife – Health and Recovery Plan (HARP), Qualified Health Plan and Essential Plan members if you go to an in-network pharmacy. You do not need a prescription from your doctor. Test Kits eligible for coverage can be found by clicking here.

I went to an in-network pharmacy, and they said I have to pay out of my pocket. What do I do?

Fidelis Care is currently working with our pharmacy partners to ensure COVID-19 tests are available at no cost if you go to an in-network pharmacy. If you purchased an at-home COVID-19 test at the pharmacy, we will reimburse you for the cost of the test after you complete the member reimbursement process. The reimbursement will be limited up to the amount set by New York Medicaid or federal guidance (up to $24, per test Kit, per covered individual).  At-Home COVID-19 tests are packaged in sets of two tests in a single box. The single box is also referred to as a “Kit.”

What if I bought a COVID-19 test on my own, will I be reimbursed?

Yes, if you purchased an at-home COVID-19 test at a pharmacy, we will reimburse you for the cost of the test after you complete the member reimbursement process. Reimbursement will require proof of purchase and is subject to the benefit’s four test Kits per month coverage limit. The reimbursement will be limited up to the amount set in New York Medicaid or federal guidance (up to $24, per test Kit, per covered individual).  At-Home COVID-19 tests are packaged in sets of two tests in a single box. The single box is also referred to as a “Kit.”

Is there a limit to the number of tests that I may obtain for free?

Yes, we will cover four (4) At-Home COVID-19 test Kits (8 tests), obtained over-the-counter, per covered individual in a 30-day period, consistent with New York Medicaid or federal guidance.

 

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For Wellcare By Fidelis Care Medicare
and Dual Advantage Members:

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Is COVID-19 testing covered by my plan?

YES, Wellcare will cover COVID-19 testing when performed in an official testing location, and/or when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional.

Is there a cost to the COVID-19 testing provided in these locations that are covered by Wellcare By Fidelis Care?

NO, Members will not have any liability for these official tests.

Does Wellcare By Fidelis Care cover over-the-counter COVID-19 at-home tests?
  • We continue to carefully monitor the pandemic and evaluate how best to serve our members during these unprecedented times. At this time Wellcare By Fidelis Care is not reimbursing members for COVID-19 at-home testing kits purchased independently online, or from a retailer.
  • CMS is launching an initiative in early spring 2022 that provides payment directly to eligible pharmacies and other entities that are participating in this initiative to enable people with Medicare to get up to eight free over-the-counter COVID-19 tests a month. All Medicare beneficiaries with Part B will be eligible to get eight free over-the-counter COVID-19 tests per month through this initiative, whether enrolled in a Medicare Advantage plan or not.
  • In the meantime, we encourage our members to receive COVID-19 tests at official testing sites by health care professionals at no cost.
Where can I locate a free at-home COVID-19 tests?

 

 

Medicare and Dual Members

Additional information on COVID-19 coverage for Medicare and Dual Advantage.

 

Early Prescription Refills and 90-day Supply

Fidelis Care is covering early refills and up to a 90-day supply of most maintenance medications for members.

This includes both prescription and over-the-counter (OTC) medications used for chronic health conditions.   Medicare Advantage, Dual Advantage, Qualified Health Plan, and Essential Plan members are also encouraged to use mail-order pharmacy for 90-day refills.  

For Fidelis Care Medicaid, Child Health Plus, and HealthierLife members, please note:

  • Medication Delivery:
    • Pharmacies that choose to provide delivery to individuals quarantined may confirm receipt of the medications by the member through a phone call, text, or email, in lieu of getting a signature.
  • Prescription transfers:
    • If a Medicaid member has had a prescription filled from a pharmacy that is inaccessible or traveling to that pharmacy is not feasible, then he/she can obtain a new prescription order from the prescriber;

OR

  • A refill of the prescription can be transferred to another Medicaid participating pharmacy where allowed by law.

*Please note, prior authorization may be required for 90-day supplies of some medications

NY State's COVID-19 Exposure Notification App Available for Download

One way you can help yourself and your community is by participating in New York State's mobile contact tracing app, COVID Alert NY.

COVID Alert NY is a voluntary, anonymous, exposure-notification smartphone app. You will get an alert if you were in close contact with someone who tests positive for COVID-19. Knowing about a potential exposure allows you to self-quarantine immediately, get tested, and reduce the potential exposure risk to your family, friends, neighbors, co-workers, and others.

The more people who download COVID Alert NY, the more effective it will be. 

Help protect your community while maintaining your privacy. The free mobile app is available to anyone 18 or older who lives, works, or attends college in New York or New Jersey and is available for download from the Google Play Store or Apple App Store

COVID Alert NY is available in English, Spanish, Chinese, Bengali, Korean, Russian, and Haitian Creole.

Learn more about how COVID Alert NY works on the State Department of Health’s website.

Locate Testing Sites Near You

To check for testing sites near you, please visit Teladoc and enter your address.  Call the coronavirus test site before you go to learn about testing criteria, availability, and hours.

Each coronavirus test provider will determine if testing is right for you, based on your symptoms, risk factors, and test availability. This information may change daily.

Remember, if you have symptoms of COVID-19, such as fever, cough, or shortness of breath, please contact your healthcare provider to discuss whether you should be evaluated for testing.


 

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