Is the COVID-19 vaccine covered?
The vaccine is available at no cost to all Priority Health members.
Note: You may receive a bill for administration of the vaccine if you use an out-of-network provider. See "Will I get a bill for the vaccine?" below for more information.
Will I get a bill for the vaccine?
No. If you see an in-network provider you shouldn’t receive any type of bill for your vaccine.
If you receive your vaccine from an out-of-network provider, we can't guarantee that a provider will not bill for any balance amounts for the administration of the vaccine. Note that the government pays for the vaccine itself.
Out of network providers don't have negotiated contract rates with Priority Health. Therefore, as is the standard practice of other health plans, we will use usual, customary and reasonable rates (UCR) to determine how much to pay an out-of-network provider.
What are usual, reasonable and customary rates (UCR)?
UCR is the amount that is paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. The UCR amount sometimes is used to determine the allowed amount.
How do I know when I am eligible for a vaccine?
The vaccine is rolled out in phases, determined by the federal and state government based on recommendations by the Centers for Disease control.
Starting April 5, Michigan residents 16 and older can get a COVID-19 vaccine.
Learn more about Michigan's vaccination timeline.
How do I get a vaccine?
Beginning on Jan 11, the Michigan Department of Health and Human service has advised that eligible individuals (as stated above) can receive a vaccination by appointment through local health departments.
Additionally, other providers like retail pharmacies and hospitals are working on creating their own registration and scheduling as they receive vaccine supplies. We recommend making appointments at your most convenient locations as they become available.
Why do I need an appointment?
There are limited vaccines in Michigan and availability varies in every county, therefore it’s important to make sure you have a confirmed scheduled appointment prior to visiting any clinic.
How do I know where vaccines are available?
MDHHS has provided the following direction:
If you are 16 and older visit michigan.gov/COVIDvaccine and select vaccine location to make an appointment with your local health department. Please remember you need an appointment to receive the vaccine. Be sure to make one before visiting your local health department.
Medicare members: Remember to bring your red, white and blue Medicare card to your appointment.
If you are an essential frontline worker, you may be notified about how and where to get a vaccine by your employer. You may also visit michigan.gov/COVIDvaccine for the most up-to-date information.
What if I don't see a number to call or a listing in my county for scheduling?
The availability of the vaccine varies by county and may change every day as vaccine distribution continues. Most counties will not schedule appointments if they don’t currently have available vaccines in hand. If you are eligible for a vaccine but are unable to schedule an appointment due to vaccine availability, check back daily for the latest updates on scheduling and availability.
Need more information about the COVID-19 vaccine?
The MDHHS website provides in-depth information on the statewide vaccine rollout, locations and information on the safety and testing of the vaccine. Visit michigan.gov/COVIDvaccine for the latest information.
Helpful COVID Vaccine FAQs from the experts:
- MDHHS (Michigan Department of Health and Human Services)
- CDC (Center for Disease Control and Prevention)
Be aware of SCAMS
Here are things you should know in case scammers try contacting you for personal information or money to get the vaccine. Remember: Vaccines are covered at no cost to you.
- You can’t pay to put your name on a list to get the vaccine.
- You can’t pay to get early access to a vaccine.
- Don’t share your personal or financial information if someone calls, texts, or emails you promising access to the vaccine for a fee.