The Health Plan Is Here to Help
The season is upon us to consider getting your annual vaccines — especially with flu season right around the corner. Vaccines help your immune system fight infections faster and more effectively. When you get a vaccine, it sparks your immune response, helping your body fight off and remember the germ so it can attack it if the germ ever invades again.
New This Year: Flu Shots and Vaccines Covered by Optum Rx
The Trustees worked with Optum Rx to improve your coverage this year. Your prescription drug benefits now cover flu shots and other vaccinations (including the vaccine for COVID-19) 100%, subject to the mandates of the Affordable Care Act (ACA), for both Tiers when you go to a retail pharmacy. You’ll need to show the pharmacist your Optum Rx ID card. We recommend contacting your local pharmacy before you go to make sure the vaccination(s) that you want are available and to check if you need to make an appointment. Just about all major retail pharmacy chains are in the Optum Rx network. You can visit Optum’s website or call them at (800) 797-9791; TTY 711 for more information.
Flu Shots and Vaccines Covered by Cigna
As a reminder, flu and other vaccination shots — including for the vaccine for COVID-19 — are also covered under the Cigna medical plan at no cost, but only when obtained from an in-network provider through the CIGNA medical plan. This also includes retail pharmacies that are in-network with Cigna. Coverage for vaccines obtained from an out-of-network medical provider will be based on the rules for your Tier of coverage.
Some of the major participating in-network retail pharmacies with Cigna include Walgreens, Rite Aid, Duane Reade, Costco, etc. For a complete list, review this flier from Cigna that lists other participating pharmacies that are in-network with Cigna. For a complete list of in-network providers, including locating retail pharmacies, please visit www.mycigna.com.
You shouldn’t need to make an appointment to get a vaccine, but you should call your pharmacy to make sure your vaccine is available at that location — and to see if they suggest making an appointment.
Please remember to use your Cigna Medical Card when getting your vaccines at the retail pharmacy. The pharmacy will need the medical ID and group number listed on your ID card. Your pharmacist may also need to use one of the following BIN and PCN codes in order to make certain that the claim submitted to Cigna gets approved:
Change Healthcare/Emdeon
- BIN: 004766
- PCN: COM62308
Omnisys
- BIN: 004303
- PCN: CIGPPOIMM
NOTE FOR CIGNA COVERAGE ONLY: CVS retail pharmacies that do not have CVS Minute Clinics and Health Hubs are considered out-of-network providers with Cigna. Only vaccines obtained at CVS locations with Minute Clinics and Health Hubs would be processed as an in-network benefit.
Questions?
If you need further information, please do not hesitate to call the Fund Office at (212) 869-9380 or toll-free at (800) 344-5220, Monday through Friday. An email inquiry can also be sent to health@equityleague.org. A representative from the Benefits Service Department can assist you between the hours of 9:30 AM to 5:30 PM Eastern Standard Time.