COVID-19 Vaccine Frequently Asked Questions (FAQ)
Answers to the Most Commonly Asked Questions Regarding the COVID-19 Vaccine
This is the most up to date version as of 01.18.2021. We will update this as more information becomes available.
When can I get a COVID-19 vaccine?
Providence is getting many inquiries from community members interested in getting the COVID-19 vaccine. We are working closely with health authorities and our provider and community partners to provide the vaccination as soon as possible.
Starting January 25, the governor of Oregon is planning to make vaccines available to child care providers, early learning, K-12 educators and K-12 staff. Eligibility, for individuals ages 80 and older, is planned to begin February 8, 2021.
Currently, COVID-19 vaccines are only available to certain high-risk individuals as determined by state and federal guidelines. This includes health care providers and staff, nursing home residents and staff, other first responders and individuals described in the state Phase 1a vaccination plan.
COVID-19 vaccine is not being offered to the general public at this time, under the direction of the local public health authorities.
Get the latest information at:
- For residents of Oregon, you can check the vaccine information by county here.
- For residents of all other states, please visit your local public health website, including county websites.
Health care providers and state and local officials are working in partnership to be sure vaccine doses are available for everyone who wants one. Masking, hand washing, and social distancing continue to be our best front line safety practices.
How do I know if I’m eligible for a vaccine?
- For residents of Oregon, you can check your eligibility for a vaccine using the Vaccine Eligibility and FAQ Tool. Once on the Oregon Health Authority (OHA) website, Vaccine Sequencing section, click on ‘Let’s get started.’ The Vaccine Information Tool chat window should appear in the lower right corner of the site page.
- For residents of all other states, please visit your local public health website.
Where can I get a COVID-19 vaccine?
When the COVID-19 vaccine is available to the general public, you will be able to find vaccinating locations through local public health authorities, 211, your personal doctor will begin to have more information, or you can call us at 1-877-216-3644 for assistance in locating a vaccinating provider.
- Medicare beneficiaries can receive their COVID-19 vaccination from any Medicare provider even if the provider is out of network for their Medicare Advantage Plan.
- For all other lines of business, members can receive their COVID-19 vaccination from any provider, even if the provider is out of network.
How much can I expect to pay for the COVID-19 vaccine?
Vaccines purchased with taxpayer dollars will be available at no cost for all members. In addition, the cost of administration of the vaccine is covered in full by any in-network or out-of-network provider.
- For Medicare Advantage plan members, providers/pharmacies must bill the administrative cost of the vaccine to Original Medicare via the Medicare Administrative Contractor (MAC).
- For all other members, providers should bill Providence directly per their standard process for the administrative cost of the COVID-19 vaccine. It is possible that out-of-network providers may indicate to you that they will not bill insurance, if that is the case, you may submit your receipt to us for payment.
Is the COVID-19 vaccine authorized by the FDA?
At this time, the Pfizer BioNTech and Moderna COVID-19 vaccines are authorized for use via the FDA’s (US Food and Drug Administration) Emergency Use Authorization (EUA). The FDA uses the EUA process to allow use of vaccines like the ones now approved for COVID-19 during a public health emergency such as the pandemic we are currently facing.
What else can members do to protect themselves?
Members should continue to follow the latest CDC guidelines—wash your hands often, avoid close contact (social distance), cover your nose and mouth with a protective cloth or mask when around others. stay home, and limit your exposure to non-household individuals. Always cover your mouth and nose with a tissue when you cough or sneeze, or use your elbow if one is not available, clean and disinfect surfaces frequently, and monitor your health daily.
Where can I find educational resources to learn more?
Below you will find some educational resources to help you learn up-to-date, and reliable information regarding COVID-19 vaccination and other information about this pandemic causing virus.
Covering costs for COVID-19 treatment Updated November 9, 2020 to extend the service date to March 31, 2021
November 9, 2020
For service dates beginning April 1 through March 31, 2021, all member cost sharing for treatment of COVID-19 will be waived. This applies to in-network inpatient, outpatient, facility and professional visits. This change is applicable for all members on an individual and family plan, small group fully insured plan and large group fully insured plan. We are working directly with our self-funded employers to determine the best approach for each of their specific needs.
Health Plan Premium Grace Period
May 8, 2020
Many individuals and businesses are already struggling to pay their health insurance premiums as a result of the impact of the coronavirus on the economy. Providence Health Plan is proactively taking action to ensure continuity of coverage – so members can continue to receive care and medications during this time of uncertainty.
- If an employer group has furloughed or laid off employees, we will continue to cover those employees contingent on payment of premium by the employer. This means that normal minimum hour requirements will be waived. COBRA may be an option for some of those employees, but this “premium continuation” approach may provide additional stability in the event employers are willing to participate in hopes that they may be able to resume business in the near term.
- People who purchase individual plans through the federal marketplace and who receive an advance premium tax credit will continue to receive a 3-month grace period, established by federal law that we will continue to follow without adjustment.
- We will grant a two month extension for the following people that are unable to pay some or all of their premium:
- People who purchase individual plans through the federal marketplace and who do not receive an advance premium tax credit
- People who purchase individual plans direct (not through the federal marketplace)
- Fully-insured employer group plans (small and large)
Failure by employers or individuals to pay all premium obligations before the end of the grace period may result in direct member liability for medical services and supplies received after the first month of the grace period. These grace period and premium continuation allowances will be available for premium attributable to March, April, May, June, July, August, September, October, November and December coverage. This message will be updated if the allowances are continued beyond that period.
Support for health plan members and Medicare beneficiaries impacted by COVID-19
March 11, 2020
Your health and the health of our communities is our priority. Effective immediately, we’ve taken the following steps:
- We are waiving all cost sharing out-of-pocket costs for testing services related to COVID-19 when ordered by a provider. Cost-sharing means things like copays, coinsurance and deductibles.
- Members are encouraged to obtain 90-day supplies of medication through their mail order pharmacy or via home delivery, and we will allow early refills for most medications
This applies to our commercial insured, large group, small group, individual and family, and Medicare members.
Providence Health Plan members who have questions about their cost share or any other issues related to COVID-19 are encouraged to contact our customer service center for additional information at 503-574-7500 or 1-800-878-4445, TTY: 711, Monday through Friday, 8 a.m. to 5 p.m. (Pacific Time).
Providence Medicare Advantage Plans members should call our Medicare customer service center at 503-574-8000 or 1-800-603-2340, TTY: 711, Monday through Sunday, 8 a.m. to 8 p.m. (Pacific Time).
To limit the possibility of person-to-person exposure of COVID-19, Providence is suspending in-person services at our Murray Business Center in Beaverton. We look forward to returning to normal services in the future.
Please note: Cost-sharing and benefits may vary depending on your plan, eligibility, changes in coverage for members or their dependents, current status of the “State of Emergency,” and status of the COVID-19 outbreak.