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The 2012-2013 Flu Season

Blue Cross Blue Shield of Massachusetts is committed to helping limit the spread of the flu virus. We make it easy for members and their families to get vaccinated this flu season by offering a range of workplace and retail-based / public vaccine solutions.

Who Should Get an Annual Flu Shot?
Experts are recommending annual flu vaccinations for everyone six months or older. For the most up-to-date information on vaccine recommendations, please visit the Centers for Disease Control and Prevention website. (Children six months through eight years of age who have never had a flu shot may need more that one flu shot. Parents should check with their child's pediatrician for more information.)

Does My Plan Cover an Annual Flu Shot?
Members with our pharmacy benefit coverage can go to any participating Express Scripts pharmacy to receive a flu vaccination from a registered and licensed pharmacist without a cost share or a prescription. Note: some states do not allow pharmacists to give flu vaccinations; please check with the pharmacy.

Plan Benefits
HMO Blue®, POS, Access BlueSM, and PPO Plans HMO Blue, POS (primary care provider/plan-approved level of benefits), Access Blue, and PPO members have no cost share for flu shots (or FluMist for children, if applicable), when performed by a participating or preferred provider. Members are covered under their medical benefits for this service. However, if a member receives a flu shot along with other covered services at a doctor's office, the other covered services will be subject to any applicable cost sharing, as outlined in the member's summary of benefits.
Indemnity Plans Most Indemnity members have coverage for the flu shot at no cost, provided your account has not opted out of National Health Care Reform's preventive care provision. Please note that if a member receives a flu shot along with other covered services at a doctor's office, the other covered services will be subject to any applicable cost sharing, as outlined in the member's summary of benefits.
Medicare Advantage Plans Medicare Advantage members have full coverage for flu shots in any location, whether or not the provider is in the Blue Cross Blue Shield of Massachusetts network. Members will be required to submit a claim for reimbursement when a non-participating doctor provides the flu shot. If a member receives a flu shot along with other services at a doctor's office, he or she will be subject to any applicable cost sharing, as outlined in the member's summary of benefits.
Pharmacy Benefit Members with our pharmacy benefits can go to any Express Scripts, Inc. participating pharmacy to receive flu vaccinations from a licensed, registered pharmacist without a cost share or a prescription. Note: Some states do not allow pharmacists to administer flu vaccinations; check with the pharmacy.

Members must have their ID card with them when they receive their flu shot.

Who Are Approved Vaccination Providers?
We have partnered with a range of doctors, hospitals, and facilities to offer flu vaccinations to members. Before receiving a flu shot, members should verify that they have coverage for that location.

Flu shot providers include:

  • Retail Pharmacies (those participating with Express Scripts, Inc.) for members with pharmacy benefits
  • Limited services clinics (e.g., MinuteClinics®' at CVS/pharmacy®')
  • Urgent care centers
  • Mollen Immunization Clinics®', offered at retail locations, such as Walmart and Sam's Club stores1
  • Member's worksite when using a vendor approved by Blue Cross Blue Shield of Massachusetts2
  • Primary care provider's office
  • Nurse practitioner's office
  • Specialist's office
  • Certified nurse-midwife's office
  • Skilled nursing facilities3 when a member is receiving outpatient services, such as physical therapy or occupational therapy
  • Home health care provider, such as a visiting nurse3
  • Outpatient department of a hospital
  • Public access clinics offered through many cities and towns

How Do I Find a Participating Provider?

Type of Provider: Go to:
Retail or Public Clinic Member Central
Doctor, in or outside Massachusetts Find a Doctor
Pharmacy—For member with pharmacy benefit coverage Express Scripts, Inc.


Prevention Tips and Treatment Options
For information on preventing the flu or finding options for treatment, please visit Member Central.

For more information, or if you are interested in scheduling a worksite flu vaccination clinic, please contact your account executive.

1. Members should find participating retail settings by visiting Member Central. Members will not be reimbursed for flu shots performed by non-participating doctors or facilities.

2. Please contact your Blue Cross Blue Shield of Massachusetts account executive for more information on approved vendors or to schedule a workplace-based flu clinic.

3. Members receiving home health care services or custodial services from a skilled nursing facility may also receive a flu shot from that participating provider without a cost share. However, any other covered services provided at the same time may be subject to a cost share.

Blue Cross Blue Shield of Massachusetts

Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association.
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