Protection against infectious diseases

For children, adolescents, and adults alike, immunizations are the best way to protect against infectious diseases. Thanks to vaccines, many infectious diseases that were once common in this country are now under control.

Holding off on immunizations because you’re worried about side effects? Don’t - in most cases, vaccines cause no side effects or only mild reactions such as fever or soreness at the injection site. Very rarely, people experience more serious side effects, like allergic reactions. And severe reactions to vaccines occur so rarely that the risk is usually difficult to calculate. Public health officials do not release vaccines unless the preventive benefits of the vaccine far outweigh any potential risks.

Immunization schedules

Keep track of which immunizations you and your family members should receive and when:

  • Immunization schedules from the Centers for Disease Control and Prevention — for children, adolescents, and adults

Seasonal Flu Coverage and Benefits

All AmeriHealth New Jersey fully-insured members have access to the flu vaccine at zero cost-share from in-network providers. Refer to the chart below to see what your plan covers and find out where you should go to get vaccinated.

Please note: The following list may not be comprehensive. If you do not see your plan here, please call Customer Service at the number on the back of your ID card for coverage information.

Your planWhere you can go for a vaccineYour coverage for the seasonal flu vaccine

Any eligible in-network provider

Any eligible provider (in- and out-of-network benefits apply)

All CVS pharmacies will not require any up-front costs if a flu shot is covered under your plan

Select RediClinics® at Rite Aid pharmacies, Walgreens® pharmacies, and some ShopRite®, Acme®, Wegmans® pharmacies may also administer the flu shot with no upfront costs, however, some locations may require up-front costs for which you can be reimbursed

Any participating in-network pharmacy

Vaccination clinics (organized by local health departments) and other private settings (e.g., place of employment).

Use the Find a Doctor tool and type in “flu” to search for a location or provider offering vaccinations near you.

All AmeriHealth New Jersey fully-insured plans cover the vaccine so you will not need a referral precertification, or preapproval to get the seasonal influenza vaccine.

If your plan does include coverage for immunizations and you paid for your influenza vaccine, you may submit a Seasonal Influenza Reimbursement Form.

Please note: For members who have 100 percent coverage for preventive services in accordance with the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010, no cost-share (i.e., copayments, deductibles, coinsurance) should be applied for the vaccine and administration of the vaccine when it is administered by an in-network provider.

Coverage is subject to the terms and conditions of the applicable benefit plan. Individual benefits must be verified.

Vaccine reimbursement

You do not need to pay an up-front fee when you get your flu vaccine at a participating location or wellness event, such as those offered by employers for their employees when facilitated by Labcorp Employer Services, any CVS and certain locations of Walgreens, Rite Aid, ShopRite, Acme and Wegmans.

If you get your flu vaccine at a location other than those listed above, you may have to pay an up-front fee. AmeriHealth New Jersey members with HMO, EPO, POS, and PPO plans who receive their vaccine at a non-participating provider may file a reimbursement form to receive reimbursement for their out-of-pocket amount of up to $50 per member, per vaccine.

To receive your reimbursement, complete the form below and mail it, along with a copy of your receipt, to:

AmeriHealth New Jersey Processing Center
P.O. Box 211184
Eagan, MN 55121

Seasonal Influenza Reimbursement Form