The Department of Employee Trust Funds is working with state health officials and health plans participating in the State of Wisconsin Group Health Insurance Program to ensure you receive the care you and/or your covered dependents need during the COVID-19 pandemic. For more information about group health insurance benefits and coverage related to the COVID-19 pandemic, visit Your Health Benefits and COVID-19.
Below you will find important information and resources about COVID-19 vaccine coverage, phases and eligibility, and availability.
COVID-19 vaccines are covered by the medical benefit for all members and by the pharmacy benefit for non-Medicare members. There is no cost for the COVID-19 vaccine.
- Medicare members: The COVID-19 vaccine will only be covered under medical insurance, Part B, of your Medicare benefit. You will need to go to a medical provider that accepts Part B coverage to receive a COVID-19 vaccine. Bring your Medicare ID card to the appointment. Medicare's pharmacy benefit, Part D, will not cover the COVID-19 vaccine.
Non-Medicare members can receive the COVID-19 vaccine at any Navitus network pharmacy. To find an in-network pharmacy near you anywhere in the United States, go to www.etf.benefits.navitus.com, click on your plan type, and the Pharmacy Search option will appear in the right-hand menu.
If you receive your COVID-19 vaccine at a pharmacy outside of the Navitus network, you may be responsible for administrative fees. To view a list of participating national and regional pharmacy chains and groups, visit the Navitus website.
Vaccine Phases and Eligibility
The COVID-19 vaccine is being distributed in a phased approach. The Wisconsin Department of Health Services determines which segments of the population are eligible for the COVID-19 vaccine in each phase. Currently eligible populations include:
- Phase 1A:
- Frontline healthcare personnel
- Residents in skilled nursing and long-term care facilities
- Police and fire personnel
- Correctional staff
- Phase 1B (beginning January 25):
- Adults over age 65
Additional priority populations may be added in the near future. For more information about eligible populations, visit the DHS website.
There is a limited supply of the COVID-19 vaccine available. If you qualify for vaccination, please work directly with your medical provider or pharmacy to ensure enough doses are available for you to be fully vaccinated. Visit the DHS website to determine if you are currently eligible for a vaccine.
The COVID-19 vaccine is typically given in two shots, one at a time, at least three weeks apart.
While you wait for your turn to receive the COVID-19 vaccine, continue to wash your hands, wear a mask, and practice social distancing. You should continue these practices even after you are fully vaccinated.
For more information about the COVID-19 vaccine, visit:
- CDC: Frequently Asked Questions about the COVID-19 Vaccine
- CDC: What to Expect Handout
- DHS: COVID-19 Vaccine Frequently Asked Questions