An updated COVID-19 vaccine has been approved by the Food and Drug Administration (FDA) and is now available in the United States. According to the Centers for Disease Control and Prevention (CDC), it is expected to protect against severe disease and death from currently circulating variants.1 CDC’s independent panel of advisors recommends everyone aged 5 years and older should get one dose of the updated Pfizer-BioNTech or Moderna COVID-19 vaccine to protect against serious illness from COVID-19.2


Keeping plan members protected


Plan members with the CarelonRx Vaccine Network and Program can continue to receive the COVID-19 vaccine at participating vaccine network pharmacies at no out-of-pocket cost. Physician offices may also carry the new COVID-19 vaccine, but members should check their benefit coverage and contact their physician offices for availability. It is anticipated that the COVID-19 vaccine will become a seasonal vaccine, like the flu vaccine.

According to the CDC, COVID-19 vaccines significantly lower the risk of getting very sick, being hospitalized, or dying from COVID-19. CDC recommends that everyone stay up to date on their vaccines, especially people with weakened immune systems.3

The new COVID-19 vaccine formulation replaces the previous government supply. Like all other vaccines recommended under the Affordable Care Act mandate, they will be covered by Commercial and Health Exchange plans with $0 member cost share, when administered at an in-network pharmacy or participating provider.


1  Centers for Disease Control and Prevention: Update on SARS CoV-2 Variant BA.2.86 (accessed September 2023): .

2  Centers for Disease Control and Prevention: Stay Up to Date with COVID-19 Vaccines (accessed September 2023): .

3  Centers for Disease Control and Prevention: How to Protect Yourself and Others (accessed September 2023): .

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