We want our members to get the most out of their healthcare coverage. Here are some common questions members ask about the shingles vaccine.

Q. What is the shingles vaccine?
A. The brand name of the vaccine is Zostavax. It is a single dose vaccine that is generally administered to adults 50 years of age and older.

Q. How old do you have to be to have HNE cover the shingles vaccine?
A. HNE covers the vaccine when administered by your In-Plan provider. HNE follows the medical guideline that the shingles vaccine is recommended for those 50 years of age and older.*

Q. Can I purchase the shingles vaccine at my pharmacy?
A. Yes. Some providers do not have it available in their office. In these cases, a member with pharmacy benefits can purchase the vaccine at a retail pharmacy with a $0 copay and then take it to the provider for administration.

Q. Can a pharmacist administer the vaccine?
A. Some pharmacists may or may not administer the vaccine. Check with your pharmacy first. Participating pharmacies may charge a $20 administration fee. Also, certain pharmacies will only administer the vaccine for those 60 years of age or older.**

Q. Is the pharmacy charge reimbursed by HNE?
A. Yes. Members can submit the itemized receipt with proof of payment if the vaccine is administered at a participating retail pharmacy. The code for reimbursement is 90736. Allow 4-6 weeks for reimbursement.

Q. What HNE insurance plans cover the vaccine?
A. All vaccines (including the shingles vaccine), with the exception of travel vaccines, are covered and considered preventive care with $0 copay if the vaccine is administered by a participating provider. Members with PPO plans using non-plan providers will be responsible for deductible and coinsurance costs. There is a $0 copay for MedPlus members, and employee sponsored Medicare Advantage plan members will be responsible for the prescription level copay for Zostavax.

Q. If I purchase the vaccine to take to my provider, how should I store it?
A. To ensure there is no loss of potency, Zostavax should be frozen. Any freezer, that has a sealed freezer door and an average temperature of -15C is acceptable for storage. Zostavax must be protected from light when transporting. For more information regarding stability, members can call 1.800.MERCK.90.

* Recommendations of the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP).

** Board of Pharmacy and the Executive Office Of Health and Human Services.