COVID-19 Vaccine: Update From Excellus

We just received the following information from Excellus regarding coverage for the COVID-19 Vaccine …

Member/Group Impact:

Vaccines approved by the U.S. Food and Drug Administration (FDA) under the Emergency Use Authorization (EUA) and recommended by the Advisory Committee on Immunization Practices (ACIP) will be covered through the end of either NY State of Emergency or the Federal Public Health Emergency.

COVID-19 Vaccine coverage, for Commercial/Employer, Exchange, Medicaid and LBS Rx, members include; No cost-share for fully insured and non-grandfathered self-funded groups.

  • No cost-share for fully insured and non-grandfathered self-funded groups
  • Coverage for vaccine administration
  • Coverage at Out of Network (OON)/“non-par” pharmacies
  • No cost for vaccine (federal government currently picking up “ingredient” cost)

COVID-19 vaccines do not require a prescription and pharmacists can administer the vaccine under a physician’s standing order. Members should check to see if their local retail pharmacy has the vaccine.

For 2021, COVID-19 vaccines for Medicare members will be covered in full through the member’s original Fee-for-Service Medicare program (“red, white and blue” Medicare Card).**Please note: the vaccine will be billed directly to Part B Medicare.**


If you have any questions, please give us a call 607-734-4291.