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COVID-19 Information

COVID-19 and Network Health

At Network Health, we understand you may have questions and concerns about COVID-19. Below you will find useful information about the virus as well as tips for staying healthy. You may also visit the U.S. Centers for Disease Control (CDC) website to learn more.

The Network Health offices are open to all guests, and we are still available to answer your questions via phone, email and member portal.

COVID-19 Benefits

As part of the COVID-19 Public Health Emergency (PHE), Network Health has been temporarily covering all COVID-19 vaccines, tests and treatments at no cost share. On January 30, 2023, the Biden Administration announced the PHE will end on May 11, 2023. This means as of May 12, 2023, Network Health plans will no longer cover COVID-19 tests and treatments at no cost share. Your plan will, however, continue to cover COVID-19 vaccines at no cost share.

How much will the COVID-19 vaccine cost me?

Medicare Advantage plan COVID-19 vaccine costs

  • If you have a Medicare Advantage PPO plan, you can get your COVID-19 vaccine at in- or out-of-network providers at no cost share.
  • As of January 1, 2022, administration fees are billed to Network Health. 
  • Please present your Network Health Medicare Advantage card at time of vaccine administration.

Commercial group and health insurance exchange COVID-19 vaccine costs

  • If you have an HMO plan, you must receive your vaccine at an in-network provider or pharmacy to have no out-of-pocket costs.
  • The administration fee will be billed to Network Health
  • Be prepared to show your Network Health member ID when you go to get the vaccine

If you are charged an administration fee for your vaccine, complete the Member Reimbursement Form and send it in to get reimbursed.

COVID-19 testing information

The Wisconsin Department of Health and Human Services is offering free over-the-counter testing kits. Each month, each Wisconsin household is eligible for one free test kit containing five rapid antigen COVID-19 tests. You can request your free monthly test kit by visiting sayyescovidhometest.org.

 

 COVID-19 Vaccine FAQ (click + icon to expand)

  1. What is the COVID-19 vaccine?
  2. Is the COVID-19 vaccine effective?
  3. Is the COVID-19 vaccine safe?
  4. What are the side effects of the COVID-19 vaccine?
  5. How does the COVID-19 vaccine work?
  6. How many shots of the COVID-19 vaccine do I need?
  7. What should I know about the COVID-19 booster vaccines?
  8. What should I know about the COVID-19 anti-viral medications?

About the COVID-19 vaccine

The U.S. Food and Drug Administration (FDA) authorized the Pfizer BioNTech vaccine for emergency use for people aged 5 to 15 years. The FDA created a fact sheet with additional information about the safety and recommended use of the Pfizer BioNTech vaccine. This vaccine has full FDA approval for individuals aged 16 years and up and emergency use for people aged 5 to 15 years old.

As of January 31, 2022, Moderna's Spikevax COVID-19 vaccine has full approval from the FDA for individuals 18 years and older. Although the Spikevax name is new, the formula remains unchanged from the previously-emergency-use-authorized immunization.

 On May 15, 2022, the FDA updated the authorization of the Janssen COVID-19 vaccine to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate, and to individuals 18 years of age and older who elect to receive the Janssen COVID-19 vaccine because they would not otherwise receive a COVID-19 vaccine.

On July 13, 2022, the FDA issued an emergency use authorization (EUA) for the Novavax COVID-19 vaccine, Adjuvanted for the prevention of COVID-19 in individuals 18 years of age and older.

Is the COVID-19 vaccine effective?

According to the New England Journal of Medicine, the two-dose Pfizer vaccine indicates 95 percent protection against COVID-19 in people age 16 and older. The two-dose Moderna vaccine provides 94.1 percent protection against COVID-19 in people age 18 and older. The single-dose Johnson & Johnson vaccine is 67 percent effective overall and 85 percent effective in preventing severe and critical cases of coronavirus.

This level of protection occurs one to two weeks after the second dose of the vaccine (for the two-dose vaccines) and two weeks after receiving the Johnson & Johnson vaccine.

On April 5, 2021, Pfizer-BioNTech provided data demonstrating that their COVID-19 vaccine remains highly effective six months after the second dose. Volunteers who took part in the initial study will be monitored by the pharmaceutical company for two years in an effort for Pfizer to determine long-term vaccine effectiveness.

Is the COVID-19 vaccine safe?

The safety of the COVID-19 vaccine is a top priority. This vaccine had to go through the same approval process as any other vaccine. The FDA only authorizes a vaccine when the expected benefits outweigh the risk. You can learn about how the FDA, CDC and other government bodies are working together to ensure the safety of the vaccine.

I've already had COVID-19. Do I still need the vaccine?

Yes, since we don’t know how long someone who has already been infected is protected and how long protection lasts, we believe the recommendation will be to get vaccinated even if you previously had coronavirus.

What are the common side effects of the vaccine?

You may experience side effects when you receive the COVID-19 vaccine. This is normal and can be a sign that the vaccine is working. These are the most common side effects.

  • Fever
  • Chills
  • Tiredness
  • Headaches
  • Pain or swelling at the vaccination site

If you have these side effects, drink plenty of fluids and rest. Even if you experience side effects from the first dose, for the two-dose vaccines, it's important to get your second dose, so you can be fully protected from coronavirus.

Contact your personal doctor if redness or tenderness increases after 24 hours or if your side effects are extreme or last longer than a few days. If you feel you are experiencing a medical emergency, call 911 or go to the nearest emergency room.

How does the COVID-19 vaccine work?

The Pfizer and Moderna COVID vaccines are mRNA vaccines, not conventional vaccines. mRNA technology is new in vaccine production but has been studied in cancer treatments for over ten years.

The Johnson & Johnson COVID vaccine is a viral vector vaccine.

The Novavax COVID-19 vaccine uses a combination of spike proteins and an immune stimulant to generate a better immune response. In comparison to mRNA and viral vector vaccine technology, Novavax uses older technology. In such vaccines, the protein is made outside the human body and then injected which generates an immune response.

Conventional vaccines

Like the annual flu vaccine, conventional vaccines need the virus to be inactivated in a lab first. This can take months to years to develop.

mRNA vaccines 

Unlike conventional vaccines, mRNA vaccines are made in a lab, without having the virus present. The coronavirus mRNA vaccine causes our cells to create a spike protein. This is a harmless protein that is found on the surface of the coronavirus. Once it's in our system, our body realizes it shouldn't be there, so it creates antibodies to fight the virus if we're infected in the future.

Froedtert and the Medical College of Wisconsin has a webpage with more information about the safety and development of the coronavirus vaccine.

Viral vector vaccines

These vaccines use a common cold virus that has been modified (called an adenovirus) to deliver the genetic material for our cells to create the spike protein. The adenovirus has been modified so it will not cause a cold and will not cause COVID. 

Once our cells create the spike protein, our body begins to create antibodies to fight the virus if we're infected in the future.

Which COVID-19 vaccines have full FDA approval?

As of September 27, 2021, only COMIRNATY — the licensed COVID-19 vaccine from Pfizer and BioNTech — has received full FDA approval for individuals 16 years and older to prevent COVID-19.

This vaccine is also authorized under EUA for the following administrations to prevent COVID-19.

  • A two-dose primary series for those individuals aged 5 through 15 years
  • A third primary series dose for those individuals aged 5 years and older who have been determined to have certain types of immunocompromise
  • A single booster dose in individuals who meet the following criteria
    • Those aged 65 years or older
    • Those aged 18 through 64 years who are identified to be at high risk of severe COVID-19
    • Those aged 18 through 64 years whose frequent institutional or occupational exposure to the coronavirus puts them at high risk of contracting COVID-19 and developing complications such as severe COVID-19

How many shots do I need for the COVID-19 vaccine?

Pfizer BioNTech and Moderna

The FDA's Pfizer BioNTech fact sheet and Moderna fact sheet are the best sources for information about protection, safety and side effects of each vaccine.

According to the FDA, these vaccines have been shown to prevent the coronavirus when two doses are given three to four weeks apart. It generally takes about two weeks for the body to generate an immune response and full protection is not obtained until the two-dose series is complete. 

Some individuals may be recommended by their health providers to receive a booster immunization. Please refer to the CDC website by clicking here for more information.

Make a plan to ensure you get the second dose when it's most effective. VaxText is a free text messaging service that will email you a weekly reminder to get your second dose of the COVID-19 vaccine if you're overdue for your second dose. Text ENROLL to 833-829-8398 to get signed up.

Johnson & Johnson

The Johnson & Johnson Janssen vaccine requires one shot. The FDA's fact sheet provides information about the protection, safety and side effects of this vaccine. About two weeks after receiving the single-dose shot, your body will generate an immune response and begin being protected from the coronavirus. 

Novavax

The Novavax COVID-19 vaccine is a two-dose vaccine, given three to eight weeks apart. It is recommended for people 18 years and older. Learn more about the new Novavax COVID-19 vaccine by viewing the FDA's fact sheet here.

Do I need to get a COVID-19 booster vaccine?

On November 19, 2021, officials at the United States Food and Drug Administration (FDA) officially cleared all Americans aged 18 and over, who are fully vaccinated, to receive booster vaccinations from Pfizer or Moderna.

If you received your initial vaccination round from the Pfizer or Moderna vaccines, you are eligible for a third-dose COVID-19 booster vaccination a minimum of six months following the latter of your COVID-19 vaccination round.

If you received your initial vaccination from the Johnson & Johnson Janssen vaccine, you are eligible for a second-dose COVID-19 booster vaccination a minimum of two months following your last COVID-19 vaccination.

For information on subsequent COVID-19 vaccine booster doses, please refer to the CDC guidelines, which are frequently updated here.

Who can get a COVID-19 booster shot?

Those 12 and over who have received their primary series of COVID-19 vaccines are eligible for one booster.

Those 50 and older, those 12 and older who are moderately or severely immunocompromised and those who got two doses of Johnson & Johnson's Janssen vaccine are now eligible for a second COVID-19 booster.

What about COVID-19 anti-viral medications?

In December 2021, two new COVID-19 anti-viral agents were granted Emergency Use Authorization by the FDA. Those anti-viral medications are Paxlovid and molnupiravir.

Paxlovid is approved for use in those 12 and older and weighing 88 lbs. or more. Molnupiravir is approved for use in those 18 and older.

As of January 5, 2022, these medications are only used in mild to moderate COVID-19 cases where there is a high risk for progression leading to hospitalization or death. Examples of high-risk patients or situations include physical frailty, being in a high-risk age group, being immunocompromised and having chronic conditions like heart disease, lung disease or diabetes.

These medications are not authorized for initiation of treatment in patients requiring hospitalization due to severe or critical COVID-19. They are not authorized for pre-exposure or post-exposure prophylaxis for the prevention of COVID-19. They are not authorized for use longer than 5 consecutive days.

Once prescribed, this medication is taken twice a day for five days. 

If you have questions about being prescribed one of these medications, please contact your doctor.


Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.

COVID-19 Information for Network Health Members