COVID-19 resources for members

We have put in place coverage policies for COVID-19 vaccines, testing and treatment, based on public health recommendations and industry guidelines that are informed by the best data and medical evidence available.

To expedite access to critical health care services for COVID-19 in accordance with guidelines from state and federal agencies, our coverage criteria--which may be updated in response to an evolving situation--includes:

• Removing cost-sharing (copayments, deductibles, or coinsurance) for medically necessary outpatient and inpatient COVID-19 testing and treatment at in-network or out-of-network providers, urgent care centers, emergency departments, hospitals, and other facilities for the duration of the public health emergency.

Note: Employers that are self-insured may have different cost sharing for these services. Please visit the Mass General Brigham Health Plan Member portal or call the Customer Service number on the back of your member ID card if you have questions about your plan.

People ages 6 months and older who live, work, or study in Massachusetts are eligible to receive a COVID-19 vaccine. People ages 6 months through 17 can receive the Pfizer or Moderna vaccine and people age 18 and older can receive any vaccine. You can find a vaccine location near you on Mass.gov/covid-19-vaccine.

The CDC also recommends a booster shot for individuals age 12 and older. Individuals who are 12-17 years old can get a Pfizer booster. Individuals 18 and older can get any booster. Additionally, individuals ages 50 or older can now get a second booster at least 4 months after their first booster. For the latest guidance on booster shots and eligibility, please visit Mass.gov.

To see the latest COVID-19 vaccination sites and schedule an appointment please visit Vaxfinder.mass.gov. Walk-in or same-day appointments are also available at local pharmacies such as CVS, Walmart, and Walgreens.

For members who require in-home vaccinations because they are unable to leave their home to get to a vaccination site, please visit the state’s COVID-19 Homebound Vaccination Program page at Mass.gov/covidvaccine.

Before your appointment, find out the latest clinical guidelines and what to expect ahead of your vaccination at the CDC website.

Yes, children 6 months and older who live or go to school in Massachusetts are now eligible to get the COVID-19 vaccine. Children ages 6 months to 17 can receive the Pfizer or Moderna vaccine. The latest information and guidance on COVID-19 vaccinations for children and youth can be found on the following Mass.gov pages:

• Children 6 months to 4
• Children ages 5-11
• Youth ages 12-17
  
  

Appointments for children at sites across the Commonwealth can be found on VaxFinder.mass.gov. Please note that some locations listed may only vaccinate certain ages so you should read the site details to learn more. For medical questions about vaccinating your child, we encourage you to contact your child’s health care provider. You can also learn more about the latest guidance on the COVID-19 vaccine for children and teens from the CDC.

Mass General Brigham Health Plan will cover the administration of COVID-19 vaccines at no cost to our members.

The COVID-19 vaccines that are being administered have received Emergency Use Authorization (EUA) or full approval from the Food and Drug Administration (FDA). EUA is a designation issued by the FDA to facilitate the availability and use of medical actions, including vaccines, during public health emergencies.

The COVID-19 vaccines that are being administered have proven to be extremely effective. Clinical trials were conducted to evaluate the safety of these vaccines, with thousands of participants across gender, age, race, and ethnicity. Visit the CDC to learn more about the safety and benefits of the COVID-19 vaccines.

The CDC also recommends a booster shot for individuals ages 5 and older. Updated “bivalent” COVID-19 booster vaccines from Moderna and Pfizer are now available for individuals 12 and older. Bivalent vaccines protect against two different viruses, or two strains of the same virus, meaning they target the original COVID-19 strain and the newer omicron variant. You are eligible for this updated booster if you have completed a primary vaccination series with one of the COVID-19 vaccines and if at least 2 months have passed since the last dose of your primary vaccine series or any booster dose. Individuals who are 5-17 years old can continue to get the original Pfizer booster.

For the latest guidance on booster shots, eligibility, and vaccine locations, please visit Mass.gov.