Staying Healthy In Flu Season:
During the flu season we want to make sure you're up-to-date on your flu facts. When you're informed and aware, you're more likely to avoid illness. Read our recommendations for staying healthy this flu season and be sure you understand your coverage.
Get a Flu Vaccine
The flu can best be prevented with the current flu vaccine, which is updated annually to most closely match the recent viral strains. Experts now recommend that everyone age six months and older get a flu vaccine each year according to the Centers for Disease Control and Prevention (CDC), people who are at higher risk for complications from influenza include, but not limited to.
- People with asthma
- People with diabetes
- People with heart disease and those who have had a stroke
- Adults 65 and older
- Pregnant women
- People who have HIV or AIDS
- People who have cancer
- Children younger than 5, especially children younger than 2 years of age
Please visit the Center for Disease Control & Prevention (CDC) for the latest list of groups considered to be at high risk of serious flu-related complications.
Important Exception for Children:
Children six months through eight years of age who have never received a flu vaccination may need more than one dose of flu vaccine in the first year they receive it. Parents should check with their child's pediatrician first.
Where to Get Vaccinate
It depends on your coverage and the location.
Medical Benefit Coverage
To find a participating provider inside or outside Massachusetts, members can use our Find a Doctor & Estimate Costs tool or contact Member Service at the number on the front of your ID card.
To find a limited services clinic, after choosing the appropriate prefix and clicking on the Find Providers button, enter your service area and check the box next to the special category Retail Health.
Most Indemnity plan members have full coverage for flu vaccines when given by a participating provider. This includes approved flu vaccine clinics in retail and public settings.
- Limited services clinic (e.g., MinuteClinics®' at CVS/pharmacy)
- Urgent care center
- Member's worksite when using a vendor approved by Blue Cross Blue Shield of Massachusetts
- Primary care provider's office
- Nurse practitioner's office
- Physician assistant's office
- Specialist's office
- Certified nurse-midwife's office
- Skilled nursing facilities (when a member is receiving outpatient custodial services, such as physical therapy or occupational therapy)
- Home health care provider, such as a visiting nurse1
- Outpatient department of a hospital
- Public access clinic offered through a city or town
- Community health center
1. 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 cost.
Pharmacy Benefit Coverage
Members who have pharmacy coverage (only 18+) can also receive a flu vaccination at Express Scripts, Inc. (ESI) participating pharmacies without a prescription. At the ESI participating pharmacy, the flu shot must be administered by a pharmacist who is licensed to perform flu vaccinations.
To find an ESI-participating pharmacy, go to http://www.express-scripts.com. You will need to choose a user name and password or log on using existing information.
If your plan offers coverage outside of Massachusetts, in addition to getting a vaccine from the options in the table above, you can use the following resources to find a convenient location:
- To find a participating provider, including a limited services clinic/retail health clinic (such as a CVS MinuteClinic), go to Blue National Doctor and Hospital FinderSM.
- Call Member Service at the number on the front of your ID card.
Please note this information is being provided for educational purposes only and should not be considered medical advice. Please consult your doctor for medical advice.
Members will not be reimbursed for flu vaccines performed by non-participating doctors or facilities, unless the member participates in Medicare Advantage.
For the 2018-2019 flu season, the CDC recommends against using the nasal spray flu vaccine, commonly supplied as Flumist. As such, Blue Cross Blue Shield Massachusetts won't cover this type of vaccine for this flu season.