Stay up to date on COVID-19

The COVID-19 pandemic is likely to raise questions about what your plan covers. Several frequently asked questions (FAQs) are addressed below, along with information on vaccine availability, and links to updated COVID-19 information. For additional questions or concerns, contact the Member Services team at (855) 624-6463, Monday through Friday, 8 a.m. to 6 p.m., or via email memberservices@healthoptions.org.

 

COVID-19 Vaccine

Q:  Which COVID-19 vaccines are FDA approved?
A:  Pfizer is one of two COVID-19 vaccines to receive FDA approval. The vaccine, previously known as Pfizer-BioNTech COVID-19 vaccine, now goes by the brand name Comirnaty. This vaccine is approved for individuals 16 years of age or older. Individuals 5 through 15 years of age can continue to receive the Pfizer-BioNTech COVID-19 vaccine under an Emergency Use Authorization (EUA).

Moderna COVID-19 vaccine has also received FDA approval. The Moderna COVID-19 vaccine goes by the brand name SpikeVax and is approved for individuals 18 years of age and older.

The table below summarizes the use of the available COVID-19 vaccines:

Q:  Where can I get the COVID-19 vaccine?
A:  All people aged 5 or older are eligible for, and encouraged to get, a COVID-19 vaccination. If you need help scheduling an appointment or want to know if a site near you is offering vaccinations without an appointment, call the Maine COVID-19 Community Vaccination Line at 1-888-445-4111, Monday-Friday, 9 a.m. to 5:30 p.m. For an updated list of COVID-19 vaccine sites in Maine, visit: maine.gov/covid19/vaccines/vaccination-sites. For translation services, call the number and state your desired language (for example: “Spanish”). Deaf and hard of hearing individuals may dial 711 and ask to be connected to the number above.

Q:  Are there vaccines available for children under age 12?
A:  Yes, Pfizer-BioNTech is the only COVID-19 vaccine currently available for children 5 to 11 years old.

  • Administered as a two-dose primary series, 3 weeks apart.
  • It is a lower dose (10 micrograms) than that used for individuals 12 years and older (30 micrograms). It is age-based and not weight-based (dose is given according to a child’s age the day the vaccine is given).
  • A third primary series dose is authorized for certain immunocompromised children 5 through 11 years of age. Please speak with your pediatrician.

Q:  Where can children 5 to 11 years old receive their COVID-19 vaccination?
A:  You may hear directly from your health care provider or your child’s school about getting a vaccine, or you may contact locations offering appointments or drop-in at locations with no appointment necessary. If you need help scheduling an appointment, or want to know if a site near you offers vaccinations without an appointment, call the Maine COVID-19 Community Vaccination Line at 1-888-445-4111 or visit maine.gov/covid19/vaccines/vaccination-sites.       

Q:  Is there a cost for COVID-19 vaccine?
A:  The COVID-19 vaccine administration charges continue to be available with no out-of-pocket costs.

 

COVID-19 Vaccine Booster

Q:  Do I need a booster dose?
A:  The U.S. FDA has approved, and the U.S. and Maine CDC recommend the use of a single booster dose in individuals 12 years of age and older. The time between the completion of primary vaccination of the Pfizer-BioNTech and the Moderna COVID-19 vaccines and a booster dose has been shortened to “at least” five months. For people who received the J&J/Janssen COVID-19 vaccine, booster shots are also recommended for those are 18 and older and who were vaccinated two or more months ago. On January 5, 2022, CDC authorized booster doses of the Pfizer-BioNTech vaccine for 12- to 15-year-olds. “Mixing and matching” is not an option for this group because the Pfizer-BioNTech vaccine is the only one cleared for use in children under 18 years.

Additionally, the CDC recommends that only moderately or severely immunocompromised 5- to 11-year-olds receive an additional primary dose of the Pfizer-BioNTech COVID-19 vaccine 28 days after their second shot.

Q:  Am I eligible for the COVID-19 vaccine booster and what COVID-19 vaccines should be used?
A:  Refer to the table below to identify who is eligible to receive booster shot:

 

IF YOU RECEIVED

Who should get a booster:

When to get a booster:

Which booster can you get:

Pfizer-BioNTech

Everyone 12 years and older

At least 5 months after completing your primary COVID-19 vaccination series

Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) are preferred in most* situations

 

Teens 12-17 years old may only get a Pfizer-BioNTech COVID-19 booster

 

Moderna

Adults 18 years and older

At least 5 months after completing your primary COVID-19 vaccination series

 

Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) are preferred in most* situations

Johnson & Johnson’s/Janssen

Adults 18 years and older

At least 2 months after receiving your J&J/Janssen COVID-19 vaccination

 

Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) are preferred in most* situations

*Although Pfizer-BioNTech and Moderna vaccines are preferred, J&J/Janssen may be considered in some situations

For more information on the COVID-19 vaccine booster, see this FAQ. To find a booster dose, find a vaccination site or call the Maine CDC COVID-19 Community Vaccination Line at 1-888-445-4111.

Q:  Who is eligible for a Second Booster vaccination? [Note:  This was authorized as an option and not a full recommendation for individuals 50 years and older.]
A:  The following individuals are eligible for an additional booster:

  • A second booster dose of the Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 Vaccine may be administered to individuals 50 years of age and older at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine.
  • A second booster dose of the Pfizer-BioNTech COVID-19 Vaccine may be administered to individuals 12 years of age and older with certain kinds of immunocompromise at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine. These are people who have undergone solid organ transplantation, or who are living with conditions that are considered to have an equivalent level of immunocompromise.
  • A second booster dose of the Moderna COVID-19 Vaccine may be administered at least 4 months after the first booster dose of any authorized or approved COVID-19 vaccine to individuals 18 years of age and older with the same certain kinds of immunocompromise.

Q:  Who are considered immunocompromised?
A:  Many conditions and treatments can cause a person to be immunocompromised (having a weakened immune system). People are considered to be moderately or severely immunocompromised if they have:

  • Been receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that may suppress their immune response

Talk to your healthcare provider about COVID-19 vaccination and your medical condition.

Q:  Is there a cost for COVID-19 vaccine boosters?
A:  Like the initial doses, COVID-19 vaccine and administration charges continue to be available with no out-of-pocket costs.   

Q:  Where can I get the COVID-19 vaccine booster?
A:  Vaccines are widely available across the state at doctors’ offices, pharmacies, and hospital clinics. You can find a vaccination site here: maine.gov/covid19/vaccines/vaccination-sites or call the Maine CDC COVID-19 Community Vaccination Line at 1-888-445-4111.

Q:  Can I get a COVID-19 vaccine and flu vaccine at the same time?
A:  Yes. Aside from the usual side effects related to your vaccines, such as soreness at the site of the injection and general feelings of lethargy and achiness, it is safe to get both your COVID-19 vaccine and your flu shot at the same time, though, for your own comfort, you may want to choose different arms.

Q:  Do I have to get a booster to be considered fully vaccinated?
A:  No. At this time, you are considered fully vaccinated once you are 14 days out from the final dose of your initial vaccine, whether that was the two-shot Pfizer or Moderna vaccines or your single-shot J&J/Janssen vaccine.

 

COVID-19 Testing

Q:  Who should be tested for COVID-19?
A:  Current US CDC guidance indicates the following people should get tested for COVID-19:

- People who have symptoms of COVID-19

- People who have had a known exposure to someone with suspected or confirmed COVID-19.

- People who are fully vaccinated should get tested 5-7 days after exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result.

- People who are not fully vaccinated should quarantine and be tested immediately after being identified, and, if negative, tested again in 5–7 days after last exposure or immediately if symptoms develop during quarantine.

- People not fully vaccinated with COVID-19 vaccine who are prioritized for expanded community screening for COVID-19.

- People not fully vaccinated with COVID-19 vaccine who have been asked or referred to get testing by their school, workplace, healthcare provider, state, tribal, local or territorial health department.

Q:  Where can I get tested for COVID-19?
A:  Maine CDC maintains an updated list of COVID-19 testing sites, organized by county, town, provider, and test type. The site also includes a description of the types of COVID-19 tests and other frequent FAQs.

As a reminder, please bring your health insurance ID card with you whenever you seek medical care, including any appointments for COVID-19 testing or vaccine administration.

 

COVID-19 related stress and anxiety

Q:  Where can I get help for COVID-19 related stress and anxiety?
A:  Health Options offers a provider lookup tool to help find a behavioral health provider near you. Health Options and some providers offer telehealth services. If you are experiencing an emergency, dial 911, go to a local emergency room or call the State of Maine Crisis Hotline at 1-888-568-1112. Mayo Clinic offers these Tips to Help You Manage Stress Related to COVID-19

 

Health Options Member information

Q:  Will Health Options cover provider appointments, screening, and treatment related to COVID-19? If so, when?
A:  Health Options is waiving cost-sharing for the following services: provider-recommended COVID-19 testing, the associated lab processing fees, and the visit to collect the specimen. All other testing, treatment, and services are subject to applicable cost-share.

 

General COVID-19 information

For all other general COVID-19 information, please visit the following sites online:

- Maine Center for Disease Control and Prevention (ME CDC) COVID-19 Updates and Information: maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/coronavirus

- State of Maine COVID-19 Response, Office of the Governor: maine.gov/covid19

- U.S. Centers for Disease Control and Prevention (U.S. CDC) COVID-19 site: cdc.gov/coronavirus/2019-ncov or call 1-800-232-4636 and choose Option 8.

- In Maine, Dial 211 or 1-866-811-5695 to receive answers about more general topics such as steps to protect oneself from the virus, testing options, and travel restrictions.

- Visit hhs.gov/coronavirus/community-based-testing-sites/index.html to view testing locations nationwide.

- Learn more about how the FDA ensures the safety and effectiveness of COVID-19 vaccines at fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines