Seasonal Flu

The recommendations for the 2011-2012 flu season from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices include flu vaccination for all people 6 months and older, especially pregnant women, children younger than 5, adults 50 and older, and anyone with a chronic illness.

This year, the seasonal flu vaccine has been combined with the H1N1 flu vaccine, so only one vaccination is required for adults. For more information about this year’s flu vaccine, visit the CDC’s flu website.

Your coverage and benefits

Whether you are covered for the vaccine depends on the type of Independence Blue Cross coverage you have. Refer to the chart below to see what your plan covers and find out where you should go to get vaccinated.

Please note: the following list may not be comprehensive. If you do not see your plan here, please call Customer Service at the number on the back of your ID card for coverage information.

Flu vaccine coverage chart

Your plan Where you can go for a vaccine Your coverage for the seasonal flu vaccine

Keystone HMO/POS

Keystone 65 HMO

adultBasic

CHIP
  • any eligible in-network provider;
  • participating MinuteClinics® at CVS pharmacies and Take Care Health Clinics™ at Walgreens® pharmacies;*
  • vaccination clinics (organized by local health departments) and other private settings (e.g., place of employment).

Coverage for the seasonal flu vaccine depends on whether your plan includes coverage for immunizations.

If your plan covers immunizations:

  • You will not need a referral, precertification, or preapproval to get the seasonal influenza vaccine.
  • You will pay any applicable copay and/or deductibles.

Please Note: For members who have zero cost-share preventive services in accordance with Patient Protection and Affordable Care Act (PPACA) of 2010 and the Health Care and Education Reconciliation Act (HCERA) of 2010, no cost-share (ie, copayments, deductibles, coinsurance) should be applied for the vaccine and administration of the vaccine.

If your plan does include coverage for immunizations and you paid for your influenza vaccine, you may submit a Seasonal Influenza Reimbursement Form (see below).

If you do not know whether your plan covers immunizations, call Customer Service at the number on the back of your ID card.

Personal Choice® PPO

Personal Choice 65SM

National BlueCard
  • any eligible provider (in- and out-of-network benefits apply);
  • participating MinuteClinics® at CVS pharmacies and Take Care Health Clinics™ at Walgreens® pharmacies in accordance with your standard benefits plan;
  • vaccination clinics (organized by local health departments) and other private settings (e.g., place of employment).
  

Comprehensive Major Medical (CMM)

Traditional Blue Cross® and Blue Shield®

The flu vaccine (injectable and the intranasal) is covered in accordance with your current benefits plan for routine immunizations. Benefit restrictions as well as applicable deductible and coinsurance requirements may apply.

Please refer to your Summary of Benefits for more information, or call the Customer Service number on the back of your ID card.

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:

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

* For a list of participating retail clinics, please refer to: Retail Health Clinics.