Flu Vaccination Coverage for Members
In most cases, a flu vaccine will have no cost for members. However, we encourage members to review their benefits or call Member Service to verify the specifics of their plan.
Coverage by Plan:
- HMO Blue, Blue Choice®, Access Blue, Blue Care® Elect, Preferred Blue® PPO, and most Indemnity plan members have full coverage (no cost) for flu vaccines when performed by participating or preferred providers, including approved flu vaccine clinics.
- Medicare Advantage members have full coverage for flu vaccines in any location, whether the provider is participating or not. Members are required to submit a claim for reimbursement when they receive a flu vaccine from a non-participating provider.
Note: The Centers for Disease Control and Prevention (CDC) recommends an annual flu shot for those aged six months and older. For the 2018–2019 flu season, the CDC also 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.
If a member receives a flu vaccine along with other covered services at a provider's office, the member is required to pay the applicable cost for the other services. This information is outlined in each plan's Summary of Benefits.