AERA News
Zostavax®?
WHAT IS ZOSTAVAX®?
®Zostavax is a single dose vaccine used to prevent shingles in patients 60 years and older.
WHERE DO I GO TO GET THE VACCINE?
Zostavax® is now covered under both the Medical and Prescriptions Plan for Alabama PEEHIP. While most vaccines are administered in the physician's office, this product is unique in that the vaccine must be administered within ½ hour of removal from storage. Check with your physician office first.
If the prescription is obtained from the pharmacy, it should be administered by a health professional, physician, or pharmacist licensed by the state of Alabama to administer vaccines within 30 minutes of dispensing.
The state of Alabama has a link to identify pharmacists in the state that are authorized to administer vaccines.
http://www.adph.org/pharmacyunit/assets/Immunizing%20Pharmacists21007.pdf
WILL THE MEMBER BE CHARGED A MEDICATION ADMINISTRATION FEE FROM THE PHARMACY?
If the pharmacy is charging an administration fee for the vaccine, the plan will reimburse the member for incurred costs up to $20.00. The member will need to submit a manual claims form with all supporting receipts to the following address:
Express Scripts
328 Varden Hill Drive
Birmingham, AL 35214
A manual claim form is available on the ESI website (member registration required):
http://www.express-scripts.com/
or the member may contact the Express Scripts Customer Service by calling 1-800-233-8065
Please allow 2 weeks for processing.
ALL Pharmacy submitted claims for medication administration fee reimbursement will be denied.
IS THE MEDICATION ADMINISTRATION FEE INCLUDED IN THE CO-PAY?
No, the 50% member co-pay includes the cost of the medication. The administration fee, if any, is determined by the pharmacy. The plan will reimburse the member up to $20.00.
IS THERE ANY OTHER VACCINE/IMMUNIZATION SERVICES COVERED UNDER THE PRESCRIPTION PROGRAM?
No. Not at this time.