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COVID-19 vaccines
- What should I know about the COVID-19 booster shot?
- Three COVID-19 vaccines are authorized for use as a booster dose at this time. Pfizer-BioNTech or Moderna (COVID-19 mRNA vaccines) are preferred. You may get Johnson & Johnson’s Janssen COVID-19 vaccine in some situations. For more information and up to date recommendations on boosters, please visit the CDC website.
- What should I know about the safety and efficacy of COVID-19 vaccines?
- The COVID-19 vaccines that are currently available have been reviewed and recommended by the Advisory Committee on Immunization Practices (ACIP) and the CDC.The CDC recommends vaccines that it has declared safe and effective. According to the CDC, millions of people in the United States have received COVID-19 vaccines, and these vaccines have undergone the most intensive safety monitoring in U.S. history.Prior to the CDC’s recommendations, clinical trials are being conducted to evaluate approved COVID-19 vaccines in many thousands of study participants. These trials generate scientific data and other information used by FDA to determine vaccine safety and effectiveness. You can learn more from the CDC, or from Oscar Medical Group’s Dr. Stephanie Reznick in these videos on our blog:
- The steps to developing a COVID-19 vaccine [Video]
- COVID-19 Vaccines: Common Questions [Video]
- COVID-19 Vaccines: Understanding mRNA [Video]
- As an Oscar member, how much will I be charged for the COVID-19 vaccine?
- The cost of the COVID-19 vaccine is $01when you visit an in-network location, such as at your local pharmacy like CVS. Select CVS locations are administering COVID-19 vaccines by appointment only, and based on local eligibility and availability guidelines. You can check your eligibility and schedule appointments where available through the CVS tool. Our $0 cost-share COVID-19 vaccine policy covers COVID-19 immunizations that have been approved by the federal government and national public health institutes like the CDC.2 You can find the latest news on COVID-19 vaccines and related regulations on the CDC’s website.
- How much will I be charged for COVID-19 vaccines if I go to an out-of-network location?
If you receive the COVID-19 vaccine at an out-of-network location, you are responsible for the full cost of the vaccine. Oscar will not reimburse you for vaccines received out-of-network.
- When will I be eligible for the COVID-19 vaccine?
- The CDC recommends COVID-19 vaccines, including boosters, for everyone ages 6 months and older. Use CDC’s COVID-19 booster tool to learn if and when you can get boosters to stay up to date with your COVID-19 vaccines. Staying up to date means getting all recommended COVID-19 vaccines including boosters when eligible. People who are moderately or severely immunocompromised have specific COVID-19 vaccine recommendations, which include a third dose to complete their primary series, as well as two booster doses for those eligible.You can find the latest updates and guidance from your state health department website via this page.
- How can I schedule an appointment?
- Find a local pharmacy near you, such as CVS Pharmacy by searching in your Oscar account online or via the Oscar App. You can also use the CVS tool to schedule appointments at a CVS in your area or visit vaccines.gov/search. Many doctor’s offices are also providing the vaccine, so you can check with your PCP.
- What should I consider before getting my COVID-19 vaccine?
- Consider if you have any allergies to ingredients in the vaccine (which can be found here) and if so discuss it with your allergist or PCP before having the vaccine. The CDC recommends that people who are starting their vaccine series or getting a booster dose get either Pfizer-BioNTech or Moderna. It is not recommended that you premedicate with ibuprofen, acetaminophen, or other pain relievers/anti-inflammatories before receiving the vaccine.
- What should I expect at my COVID-19 vaccine appointment?
- You should take every precaution to stay safe and avoid exposure to COVID-19 during your visit. Follow CDC guidelines for reducing your risk, including but not limited to wearing a mask, covering your nose and mouth, and stay at least 6 feet away from others while inside and in lines. Following vaccination, you should stay on site so that health care professionals can monitor you for any allergic or adverse reactions. According to the CDC, people who have had severe allergic reactions or who have had any type of immediate allergic reaction to a vaccine or injectable therapy should be monitored for at least 30 minutes after getting the vaccine. All other people should be monitored for at least 15 minutes after getting the vaccine.You should also receive a vaccination card or printout that tells you what COVID-19 vaccine you received, the date you received it, and where you received it, as well as a paper or electronic version of a fact sheet that tells you more about the specific COVID-19 vaccine you are being offered.Depending on the specific vaccine you get, two doses may be required, with a second shot 3-4 weeks after your first shot needed to get the most protection the vaccine has to offer against this serious disease. Oscar will cover the cost of both doses of the COVID-19 vaccine at $0 co-pay when you visit an in-network location.
- What are the common side effects of the COVID-19 vaccines?
- COVID-19 vaccination will help protect you from getting COVID-19. You may have some side effects, which is a normal sign that your body is building protection. These side effects may affect your ability to do daily activities, but they should go away in a few days. So far, most people have only experienced minor side effects, if any at all. With most COVID-19 vaccines, you will need two shots in order for them to work most effectively. The CDC recommends that you get the second shot even if you have side effects after the first one, unless a vaccination provider or your doctor tells you not to get a second shot. According to the CDC, the most common side effects of the currently available COVID-19 vaccines, and recommended actions based on side effects you might experience, include but are not limited to:
- Potential side effect: Pain or swelling on the arm where you got the shot.
- CDC recommended action: Apply a clean, cool, wet washcloth over the area, and/or use or exercise your arm.
- Potential side effects: Fever, chills, tiredness, throughout the rest of your body, and/or headaches.
- CDC recommended action: To reduce discomfort from fever, drink plenty of fluids and/or dress lightly.
- Potential side effect: Pain or swelling on the arm where you got the shot.
- What happens if I can’t make my second dose appointment as scheduled?
The CDC says that you can receive the second dose, if applicable, of your COVID vaccine up to 6 weeks after the first dose. While not providing explicit guidance for those who have waited more than 6 weeks, the CDC does state that there is not a reason to start the series over.
- What is the difference between an additional dose and a booster shot?
Some people who are immunocompromised don’t build adequate levels of protection after receiving their two-dose initial mRNA COVID-19 vaccination. Getting an additional dose can sometimes help them build more protection against the disease. Immunocompromised patients are eligible to get a third dose of Pfizer or Moderna mRNA vaccines at least 28 days after their second dose. These patients should still receive a booster six months after receiving their third dose, as the third dose is considered part of the initial series for immunocompromised individuals and not a booster.
A “booster shot” refers to another dose of a vaccine that is given to someone who built enough protection after vaccination, but then that protection decreased over time.
COVID-19 & health insurance
- How much will I be charged for COVID-19 testing?
Oscar will cover diagnostic testing for COVID-19 when provided under the network at the member’s lab benefit cost-sharing.
- How much will I be charged for COVID-19 treatment?
- Treatment for COVID-19 is now covered under your health plan benefits. You’ll just have to pay your plan's normal cost-sharing rate, which may include payments up until your deductible is met, or coinsurance or copays.
- Is Oscar covering telemedicine visits delivered by other providers?
- Oscar understands the importance of having access to medical services while many of us are staying at home to help reduce the spread of COVID-19. We continue to offer $0 telemedicine to most of our members through Oscar's Virtual Urgent Care.Oscar also has expanded telemedicine coverages policies in the following states:
- NJ: Oscar will continue to waive member cost sharing for in-network telemedicine and telehealth visits for the duration of both the state of emergency and the public health emergency related to COVID-19 declared by the Governor.
- All other states: Oscar will cover medically-necessary telemedicine care with in-network providers, subject to cost-sharing as if done in-person.
- As an Oscar member, what COVID-19 resources do I have access to?
- If you are concerned you’ve contracted COVID-19 and/or need help deciding if you need medical care, the CDC recommends contacting your primary care physician as a first step. If you are experiencing a medical emergency, please call 9-1-1. If it is not a medical emergency, you can contact Oscar’s Virtual Urgent Care, available 24/7 at $0 on most plans. Established Virtual Primary Care patients can reach out to their PCP directly through the Oscar app.
- What should I do if I get sick while traveling? Will my care be covered?
- We offer worldwide emergency coverage for life or limb emergencies. Out of network emergency care is covered if delivered at an emergency department until the member is stabilized. If you received care overseas, Oscar will need specific information to process your claim. We recommend obtaining the documentation before returning home. Contact your Care Team to discuss what documentation is needed. Be sure to reference the latest CDC guidelines for domestic, international and cruise ship travel.
- Does Oscar cover the cost of the antibody test?
Oscar will cover serological (antibody) tests that are ordered by a physician or authorized health care professional when ordered in an acute/emergent facility setting and are medically necessary for diagnosis or treatment of COVID-19 or multisystem inflammatory syndrome (MIS).
COVID-19 & seeking care
- What is COVID-19?
COVID-19 is the infectious disease caused by the most recently discovered coronavirus, SARS-CoV-2. Coronaviruses are a family of viruses which also include SARS, MERS and the common cold.
- What are the signs and symptoms of COVID-19?
- The most common symptoms of COVID-19 are fever, dry cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. Some people have aches and pains, nasal congestion, runny nose, sore throat, or diarrhea. These symptoms are usually mild and begin gradually. Symptoms may appear 2-14 days after exposure, according to the CDC.Over-the-counter cold and flu medications can be used to manage symptoms. If your symptoms worsen, such as a fever that does not decrease with medications such as acetaminophen, you should contact a healthcare professional. Please note, a fever alone that improves with over-the-counter medication does not typically require additional medical care. Your Care Team can help you determine if you need medical attention, schedule a call with a Oscar Virtual Urgent Care, or find an appointment with a provider, if necessary.If you develop emergency warning signs for COVID-19, you should seek medical attention immediately. According to the CDC, emergency warning signs include:
- Difficulty breathing where you are not able to walk across a room without needing to stop, or worsening lightheadedness.
- Have shortness of breath with lips turning blue.
- Persistent pain or pressure in the chest.
- Passing out or having an altered mental status (unusual confusion).
- How does COVID-19 spread?
- Over the course of the pandemic, there has been some debate about whether COVID19 spreads as an airborne versus a droplet infection, with the latter spreading farther in the air. The CDC states the virus spreads from person-to-person in the following ways:The virus spreads from person-to-person:
- Breathing in the virus from the air, such as after an infected person coughs or sneezes.
- Virus coming in contact with one's mucous membranes (nostrils, eyes, mouth), such as from an infected person coughing or sneezing.
- Touching mucous membranes with hands contaminated with the virus.
- How can I reduce my risk of contracting COVID-19?
- To avoid being exposed to the virus and to prevent illness, the CDC recommends the following:
- Becoming fully vaccinated
- Avoid close contact with people who are sick.
- Maintain social distancing of at least 6 feet from others not within your household.
- Avoid touching your eyes, nose, and mouth.
- Stay home when you are sick.
- Cover your mouth and nose with a cloth face cover when around others.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom and before eating; and after coughing, sneezing, or blowing your nose.
- If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol. Beware of the FDA recall list of hand sanitizers containing methanol, which are not safe to be used.
- Monitor your health daily.
- Who is at high-risk for complications from COVID-19 if infected?
- While anyone is at risk of COVID-19 if they are exposed, some people are more likely to become very sick if they are infected. People at higher risk include:
- Older adults
- People who have serious chronic medical conditions like:
- Heart disease or other serious heart conditions
- Sickle cell disease
- Diabetes
- Lung disease, including moderate to severe asthma
- Obesity (BMI of 30 or higher)
- People with chronic kidney disease, including those undergoing dialysis
- People with liver disease
- And others as noted on the CDC website.
- People are considered to be immunocompromised if they have:
- Been receiving active cancer treatment for tumors or cancers of the blood
- Received an organ transplant and are taking medicine to suppress the immune system
- Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
- Should I wear a face mask?
- Per the CDC, masking recommendations are based on community spread level, which can be checked here.
- What if I’m concerned that I have contracted COVID-19?
- If you’re experiencing COVID-19 symptoms outlined above , like a fever or cough, you should stay home and monitor your symptoms, such as by taking your temperature. Please note that a fever alone is not an indicator of the need to seek medical attention.If your symptoms worsen and you need help deciding if you need medical care, the CDC recommends contacting your primary care physician as a first step. Your provider can assess your symptoms and recommend the best course of action for you. We recommend calling provider offices in advance of going in-person. You can also contact Oscar’s Virtual Urgent Care. If you are experiencing a medical emergency, please call 9-1-1.If you have other clinical questions, like what over-the-counter medication to use, reach out to your provider or Virtual Urgent Care.If you have been told to isolate by a doctor, you should stay isolated in your home and stay in a room separate from others as much as possible. If a mask is available, please wear it to avoid infecting others, or wear a face covering. Try to use separate utensils than those used by others in your home. A household member should disinfect all high touch areas (tables, countertops, doorknobs, faucets, etc.) frequently.
- Where do I go to get tested for COVID-19?
- If you prefer for a healthcare professional to administer testing, find a testing site near you, and make sure that the location is in-network.
- Are treatments available for Covid-19?
- If you test positive for COVID-19, there are antiviral and monoclonal antibody treatments available that can reduce your chances of hospitalization or death from severe disease. Contact your healthcare provider as soon as possible after diagnosis to determine if you are eligible for treatment. Treatment must start within days of when symptoms first develop to be effective. Learn more on the CDC website.
- I have a chronic condition that puts me at high-risk for COVID-19. What should I do?
- Make sure you are fully vaccinated – including a booster shot when due – as soon as possible, unless otherwise advised by your doctor.
- Ask your doctor if you should receive a third dose (for immunocompromised patients).
- Continue to wear a mask in public (consider using a KN94 or other high grade mask), follow social distancing recommendations, and wash your hands frequently/use hand sanitizer with at least 60% alcohol in it.
- What is Long COVID? What is post-COVID syndrome?
Some people who have been infected with Covid-19 can experience long lasting effects from their infection. This is also referred to as post--COVID syndrome. These patients continue to have symptoms weeks, and sometimes months, after the initial infection. Symptoms are extremely varied and non-specific (meaning a lot of other conditions can cause similar symptoms), but common symptoms include fatigue, shortness of breath, chest pain, and cough. Some patients complain of dizziness, neurologic issues, brain fog, skin conditions, issues with their digestive tract, and so on.
A lot remains unknown about post-COVID syndrome, but the medical community continues to work hard to discover how to improve how it is diagnosed and treated. In the meantime, symptom-based treatments have been successful.
- Who is at risk of developing post-COVID syndrome or becoming a long-hauler?
It appears that those with pre-infection chronic conditions or more serious infections with COVID are at higher risk, but even young, previously healthy patients who develop an asymptomatic infection may go on to develop one or more long-Covid symptoms.
- What if I think I may have long Covid or have post-COVID syndrome?
If you think you have symptoms of long Covid please reach out to your PCP or another healthcare professional to discuss next steps. Many hospital systems have post-COVID clinics, but may have long wait lists. Remember not all post-COVID clinics are in network for Oscar members.
Contact your Care Team
If you have any questions, you can check in with your Oscar Care Team via your online account or the Oscar App, or at (855) 672-2755.