Health

Pfizer provides comprehensive medical, dental, and vision coverage. We are proud to offer the following benefits that support our enrolled colleagues and dependents.

Medical and Prescription Drug Coverage

Pfizer provides robust coverage, including no cost preventive care as well as medical and behavioral health services, emergency care, and prescription drug coverage. The Pfizer Medical Plan also provides no cost Expert Medical Opinion services through Health Navigator, powered by PinnacleCare, to help identify specialty providers and guide you when managing a serious or complex diagnosis that is newly diagnosed or when there is a change in diagnosis or treatment.

Covered services also include access to diagnostic testing, medical device equipment, and services, including but not limited to:

  • Routine hearing exams, hearing aids, and cochlear implants
  • Low vision therapy programs
  • Prosthetic devices and medically necessary supplies and accessories*
  • Mobility-related Durable Medical Equipment (DME), such as ambulatory assist devices (e.g., walkers, canes, crutches), wheelchairs, power mobility devices, commode chairs, hospital beds and accessories, power air flotation beds, seat lifts, and patients lifts, etc.*
  • Non-mobility-related medical devices, such as home oxygen therapy, oxygen therapy delivery systems, nutritional support (e.g., enteral or parenteral feedings as sole source of nutrition), etc.*
  • Behavioral health services
  • Applied Behavioral Analysis (ABA) Therapy*
  • Evaluations, such as Autism-specific developmental evaluations, cognitive and adaptive behaviors evaluations, speech, language, and comprehensive communication evaluations, etc.*
  • Speech therapy, occupational therapy, and physical therapy services*
  • Feeding therapy services*
  • Diagnostic lab tests deemed medically necessary for specific diagnoses

*Subject to medical necessity review.

Your cost for covered medical and prescription drug services will vary based on the Pfizer Medical Plan option elected. Refer to the Summary Plan Description (SPD) located in the Reference Library on netbenefits.com for coverage details.

For questions about covered services and to understand which services or medications may require pre-authorization, contact your medical plan administrator (Horizon, UnitedHealthcare/Optum (for mental health services if enrolled with UHC) or CVS Caremark (for medications dispensed through a pharmacy). You can also refer to the plan’s Summary Plan Description (SPD) located in the Reference Library on netbenefits.com.

Mental Health

Pfizer offers a variety of confidential mental health and substance use disorder support resources — including both in-person and virtual therapy:

  • Healthy Pfizer Living, which provides up to eight (8) counseling visits per issue per year at no cost for all Pfizer colleagues and their family members who live in their household.
  • Both Horizon and UnitedHealthcare/Optum (if you are enrolled with UHC) provide confidential support for a variety of mental health concerns from chronic stress to more complex issues as well as ABA therapy; available to colleagues and eligible dependents enrolled in Pfizer’s Medical Plan.
  • Spring Health, where you can take a no cost assessment and connect with a Care Navigator for help finding the most appropriate care; available to colleagues and eligible dependents (age 6+) enrolled in Pfizer’s Medical Plan. You can also access Spring Health's Neurodiversity Hub which provides centralized access to personalized support and tailored resources for youth, parents, and individuals. It includes educational content as well as access to specialized therapists for Autism Spectrum Disorder, Attention Deficit Disorder, Obsessive-Compulsive Disorder, and other conditions. As a reminder, a coinsurance or copay applies for therapy sessions based on your Pfizer medical plan option.
  • Health Navigator, powered by PinnacleCare, helps you identify and schedule appointments with expert providers and understand different treatment options for more serious or complex conditions; available at no cost to colleagues and eligible dependents enrolled in Pfizer’s Medical Plan.

Visit the Mental Health & Substance Use page on mypfizerbenefits.com for more details.

Medical Plan Administrator Support

Personalized support is available at no additional cost through your medical plan administrator to help navigate coverage for your individual medical needs. Contact your medical plan administrator (Horizon or UHC/Optum) and ask to speak to a representative.

Health Insurance Claims Support

If you need to escalate a concern you have with your Pfizer health care coverage, Participant Advocacy Services can guide you through issues you experience with your Pfizer health coverage, prior authorizations, claims submissions, and appealing denied claims. Visit mypfizerbenefits.com to learn more about getting help with a claim.

Dental Coverage

Pfizer offers two Dental Plan options (Comprehensive and Enhanced), administered by Delta Dental of New York, which provide coverage for preventive care as well as basic, major, and orthodontia services.

Nitrous oxide is covered for children up to age 19, provided Delta Dental determines the service to be medically necessary. You can also refer to the plan’s Summary Plan Description (SPD) located in the Reference Library on netbenefits.com.

Vision Coverage

The Pfizer Vision Plan, administered through EyeMed Vision Care provides coverage for routine eye care expenses, including annual eye examinations, lenses (single, bifocal, trifocal, or progressive lenses) and one pair of frames or contact lenses (including medically necessary contact lenses). The plan also offers discounts for laser vision correction.

This guide contains information about the U.S. Pfizer benefit plans, programs, and policies; however, it is not intended to provide every detail. More information can be found in the Summary Plan Descriptions, and complete details will be included in the plan document. In all cases, your benefits at Pfizer are subject to the terms and conditions of the plan document. In the event there is a conflict between the information you read in this guide and the official plan document, the plan document will control. While Pfizer expects to continue the benefits described in this guide, it reserves the right to amend, modify, suspend, or terminate the benefit at any time and for any reason, with or without notice.