Flu Shot

Your 2011 Flu Shot Guide

October 4, 2011

in Wellness

As flu season nears, questions are sure to arise about how the flu shot will be covered under your health insurance plan, where you can get a flu shot, when you should get a flu shot and many others. Knowing that all our clients are not covered by the same insurance carrier, we have compiled all the information you will need about flu shots in one place. Whether you have health insurance through CIGNA, Anthem, UnitedHealthcare or Rocky Mountain Health Plans, this is your readily available guide to use when you need to start making decisions on a flu shot.

Flu Shot 101

First and foremost, you should know the basics about the flu shot:

  • Why get the flu shot?
  • Who should get the flu shot and when?
  • Who should not get the flu shot?
  • What are the risks of getting the flu shot?

The Center for Disease Control (CDC) has developed a clear and concise to help you answer all the above questions, all in one place. Please read that document here.

The Flu Shot and Your Health Care Coverage

So you read the CDC information on flu shots and you have decided to get a flu shot. Now what?

If you do not have health insurance, the answer is pretty easy. Call your doctor or go to your local pharmacy. The cost of a flu shot is fairly inexpensive and if it saves you from getting the flu, taking a sick day at work or missing out on a paid day of work all together, then the cost is worth it.

And if you do have health insurance, the answer is almost just as easy. To make it really easy, we have broken down the information below about how each insurance carrier we work with will cover the flu shot. Find the insurance company you have your health insurance with and read on to find out how the flu shot will be covered under your health insurance plan. And as always, if you have further questions, please call us.

Anthem

Anthem will cover the flu shot based on a couple of factors: whether or not your health insurance plan is “grandfathered” or not and where you go to receive the flu shot. Basically, if your group health insurance plan with Anthem is considered “non-grandfathered”, the flu shot is covered at 100%, provided the flu shot is given in either an in-network physician’s office or in-network pharmacy. As the terms “grandfathered” and “non-grandfathered” are relatively new terms that came out of health care reform implementation, many of you likely do not know whether your plan is grandfathered or not. In that case, please call our office and we will be happy to help you find out how the flu shot will be covered under your plan.

If you receive a flu shot at a clinic that is out of the Anthem network, Anthem will reimburse you up to $25. To be reimbursed, you will need to complete a flu shot claim form. You can view the flu shot claim form here and submit to our office once complete.

For a comprehensive list of preventive health services covered by Anthem, view the PDF here. Anthem has added several new screening tests, counseling intervention services and has added services associated with previously covered screenings and vaccines.

CIGNA

Starting October 1st, 2011, CIGNA has partnered with several pharmacies and retail locations to administer the flu shot. Locations include Albertson’s Pharmacy, CVS, King Soopers, Rite Aid, Safeway, Target and Walgreens. You can also use their online provider directory to find other participating providers, such as physicians or other locations where you can get the flu shot. The flu shot will then be billed to CIGNA in accordance with your health plan.

UnitedHealthcare

Flu shots are covered at 100% if received during a physician office visit that is an in-network provider.

Also, flu shots are covered at 100% at the following retail pharmacies: The Little Clinic, RediClinic, Walgreens, CVS and Target. If a flu shot is received at the pharmacy counter at King Soopers, Safeway or Wal-Mart, members may incur added costs. However, if the flu shot is received through a convenience care clinic at the above mentioned locations (King Soopers, Safeway or Wal-Mart), the flu shot will be covered at 100%.

UnitedHealthcare has developed a nice flyer on locating flu shot providers in your area and even compiled information on work site clinics. Take a look at that PDF here.

Rocky Mountain Health Plans

Flu shots are covered at 100% if received during a physician office visit that is an in-network provider.

Visit one of the following pharmacies and the flu shot will also be covered at 100%: Albertsons, City Market, Colorado Flu Clinics (CIPAC), King Soopers, Rite Aid, Safeway, Target or Walgreens.

We realize making the best choices when it comes to your health care dollars is important to you, so we hope the above guide is helpful to you. But the bottom line is: don’t be one of the 5-20% of the U.S. population that develops the flu each year or one of more than 200,000 hospitalizations from flu-related complications. As most insurance companies either cover the flu shot at 100% or with minimal cost to you, we urge you to take advantage of this benefit.

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