Flu Vaccine Coverage
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Getting vaccinated is the best way to avoid the flu. The flu vaccine is recommended for everyone 6 months or older and is updated each year to closely match the most recent viral strains. We've partnered with doctors, hospitals, workplaces, and pharmacies to make it more convenient for you and your family to get vaccinated.

Our HMO Blue, Blue Choice, Access BlueSM, and Blue Care ElectSM and Preferred Blue PPOSM members have full coverage for flu shots administered by participating or preferred providers, including approved flu vaccine clinics in retail and public settings.

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.

Most Indemnity plan members have full coverage for flu vaccines when given by a participating provider, including approved flu vaccine clinics in retail and public settings.

In most cases, there will be no cost for your flu vaccine. However, we encourage you to review your benefits or call Member Service to verify that this applies to your specific plan.

Also, if you receive a flu vaccine along with other covered services at a provider's office, you are required to pay the applicable cost share of the other services. This information is outlined in your plan's Summary of Benefits.

Please note: For the 2017-2018 flu season, the Centers for Disease Control (CDC) recommends against using the nasal spray flu vaccine, commonly known as FluMist. Accordingly, Blue Cross Blue Shield of Massachusetts won’t cover this type of vaccine for this flu season.

Where To Get Vaccinated
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Medical Benefit Coverage

To find a participating provider, use our Find a Doctor tool or contact Member Service at the number on the front of your ID card.

Once you know what's covered, here's where to go to get vaccinated:

  • Limited services clinics (e.g., MinuteClinics®' at CVS)
  • Urgent care center
  • Worksite location (if administered by a Blue Cross Blue Shield Massachusetts contracted vendor)
  • Primary care provider's office
  • Nurse practitioner's office
  • Specialist's office
  • Certified nurse-midwife's office
  • Skilled nursing facility (when a member is receiving outpatient custodial services, such as physical therapy)
  • Home health care provider (in the member's home or at a flu clinic hosted by a home health provider)
  • Outpatient department of a hospital
  • Public access clinic offered through many cities and towns
  • Community health center

Pharmacy Benefit Coverage

Members 18 and over, who have pharmacy coverage, can also receive a flu vaccination at Express Scripts, Inc. (ESI) participating pharmacies without a prescription. The flu shot must be administered by a pharmacist who is licensed to perform flu vaccinations. To find an ESI-participating pharmacy, go to express-scripts.com. You will need to log in or choose a user name and password.

*Members receiving services from a skilled nursing facility may also receive a flu vaccine from that participating provider without a cost share. However, any other covered services provided at the same time may be subject to a cost.

Outside Massachusetts?

If your plan offers coverage outside of Massachusetts, you can also use the following resources to find a convenient location:

  • To find a participating provider, including a limited services clinic/retail health clinic (such as a CVS MinuteClinic), go to Blue National Doctor and Hospital Finder(SM).
  • Call Member Service at the number on the front of your ID card.

Note: This information is provided for educational purposes only and should not be considered medical advice. Please consult your doctor for medical advice.

Other Notes

Members will not be reimbursed for flu vaccines performed by non-participating doctors or facilities, unless the member participates in Medicare Advantage.

For the 2017-2018 flu season, the CDC recommends against using the nasal spray flu vaccine, commonly supplied as FluMist. As such, Blue Cross Blue Shield Massachusetts won't cover this type of vaccine for this flu season.

Who Should Get a Flu Vaccine?
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Flu vaccines are crucial to reducing your risk of illness and stopping the spread of the flu virus. Experts now recommend that everyone age six months and older get a flu vaccine each year. According to the Centers for Disease Control and Prevention (CDC), people who are at higher risk for complications from influenza include, but not limited to:

  • People with asthma
  • People with diabetes
  • People with heart disease, and those who have had a stroke
  • Adults 65 and older
  • Pregnant women
  • People who have HIV, or AIDS
  • People who have cancer
  • Children younger than 5, especially children younger than 2 years of age.

Please visit the CDC for the latest list of groups considered to be at high risk of serious flu-related complications.

Important Exception for Children: Children six months through eight years of age who have never received a flu vaccination may need more than one dose of flu vaccine in the first year they receive it. Parents or guardians should check with their child's pediatrician first.

Flu Prevention Tips
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Whether it's the seasonal flu or the common cold, the best way to stay healthy is to practice good hygiene, which can help reduce the spread of germs. Use these effective methods:

  • Cover your mouth and nose with a tissue when coughing or sneezing. Throw out the tissue in the nearest wastebasket, then immediately wash your hands with soap and water.
  • Don't sneeze into your hand if you don't have a tissue. Instead, use the crook of your arm.
  • Frequently wash your hands with soap and water. When hand washing is not possible, use antiseptic hand gels that contain alcohol.
  • Stay at least three feet away from people who are coughing or sneezing.
  • Immediately wash your hands after contact with an ill person.
  • Stay at home when you're sick.
  • Keep your children at home when they're sick.
  • Teach your children good hygiene habits.
  • Ask for a mask if you go to a doctor's office or hospital when you're sick.

Please note this information is being provided for educational purposes only and should not be considered medical advice. Please consult your doctor for medical advice.

If you think you have the flu, you should:

  • Avoid contact with others, get rest, stay hydrated, and seek treatment early on.
  • Consult your doctor for the best treatment, but also be aware of emergency warning signs that require urgent medical attention.
  • Call the Blue Care Line℠, our 24-hour nurse line at 1-888-247-BLUE (2583) with questions related to your health.