Stay Healthy During Flu Season
During flu season, we want to make sure you're up to date on our recommendations for staying healthy and you understand what your plan covers.
Get a Flu Vaccine
The best way to protect yourself from the flu is with the current flu vaccine, which is updated annually to most closely match the recent strain of the virus. According to the Centers for Disease Control and Prevention (CDC), the flu shot is recommended for everyone aged six months and older, and healthy individuals aged two to 49 can get the nasal spray vaccine, commonly known as FluMist.
The CDC website also includes a list of those who are considered to be at high risk for serious flu-related complications, such as:
- People with asthma, diabetes, heart disease, HIV or AIDS, cancer, and those who have had a stroke
- Adults 65 and older
- Pregnant women
- Children younger than five, especially children younger than two years of age.
Note: The CDC recommends an annual flu shot for those aged six months and older. For the 2018-2019 flu season, the CDC also now recommends FluMist for those aged two to 49 years, as well as the Flublok vaccine for those aged 18 years and older. Blue Cross Blue Shield of Massachusetts covers the cost of all FDA-approved vaccines, based on availability, if they're administered by an in-network provider. Members won't be reimbursed for flu vaccines performed by non-participating providers, unless the members have Medicare Advantage.
Important Note for Children
Children aged six months through eight years who have never received a flu vaccine may need more than one dose when they first receive it. Parents should check with their child's pediatrician first.
Where to Get a Vaccine with Medical Benefit Coverage
Most members have full coverage for flu vaccines when given by a participating provider. This includes approved flu vaccine clinics, as listed below:
- Health care professional’s office
- Limited services clinic (e.g., CVS MinuteClinic®´)
- Urgent care center
- Community health center
- Public access clinic sponsored by cities or towns
- Hospital outpatient department
- Skilled nursing facility (where a member is receiving outpatient custodial services, such as physical therapy or occupational therapy)
- In the member’s home (when given by a home health care provider, such as a visiting nurse)
- At work (when given by a Blue Cross contracted vendor)
To find a participating location that can administer a flu vaccine, members can use our Find a Doctor & Estimate Costs tool, or call Member Service at the number on the front of their ID card.
To find a limited services clinic, members can select their health plan product in our search tool and designate their location, then tap Urgent Care Centers. On the results page, the drop-down menu under Specialties in the right column will narrow the list down to retail health centers only.
*Members receiving home health care services or custodial services from a skilled nursing facility may also receive a flu vaccine from that participating provider without a cost share. However, any other covered services provided at the same time may be subject to a fee.
Where to Get a Vaccine with Pharmacy Benefit Coverage
Members who have pharmacy coverage (18+ only) can also receive a flu vaccine at pharmacies that are affiliated with Express Scripts, Inc. (ESI), an independent company, as long as the vaccine is administered by a pharmacist who is licensed to perform flu vaccinations.
To find an ESI-participating pharmacy, members can go to expressscripts.com. Members will need to create an ESI account, or log in with existing credentials.
Where to Get a Vaccine Outside Massachusetts
For plans that offer coverage outside of Massachusetts, members can also use the following resources to find a convenient location to get a flu vaccine:
- Find a participating provider, including a limited services clinic or retail health clinic (such as a CVS MinuteClinic), at Blue National Doctor and Hospital Finder
- Call Member Service at the number on the front of their ID card
Please note: This information is being provided for educational purposes only and shouldn’t be considered medical advice. Please consult a doctor for medical advice.