Home Find a Health Insurance Plan Find a Health Care Provider For Members For Employers For Health Care Providers
Get Personal. Manage your account online, anytime, with ibxperess.com.

Vaccine Reimbursement

If you get your flu vaccine at a nontraditional location, like a worksite, grocery store, community center, or other location, you may have to pay an up-front fee. Independence Blue Cross members may file a reimbursement form for this expense (up to $25 per member, per vaccine). If your coverage has copays or deductibles for vaccines, they may apply.

To receive your reimbursement, complete the appropriate form below and mail it, along with a copy of your receipt, to:

H1N1 vaccine reimbursement

IBC — H1N1
P.O. Box 69357
Harrisburg, PA 17106-9357

PDF icon H1N1 Flu Reimbursement Form

Seasonal flu vaccine reimbursement

Keystone Health Plan East / Keystone 65 HMO
P.O. Box 69353
Harrisburg, PA 17106-9353

Personal Choice® / Personal Choice 65SM PPO
P.O. Box 69352
Harrisburg, PA 17106-9352

PDF icon Seasonal Influenza Reimbursement Form