Staying Healthy In Flu Season:
During the flu season we want to make sure you're up-to-date on your flu facts. When you're informed and aware, you're more likely to avoid illness. Read our recommendations for staying healthy this flu season and be sure you understand your coverage.
Get a Flu Shot
Flu shots 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 shot each year. However, the Centers for Disease Control and Prevention (CDC) suggest that the following groups are at highest risk and in greatest need:
- Pregnant women
- Adults 65 years and older
- Health care workers and emergency medical responders
- People who live in nursing homes and other long-term care facilities
- People of any age with underlying medical conditions (e.g., asthma, diabetes)
- People caring for infants under six months of age
- Children younger than five, but especially children younger than two years old (see exception below for children six months through eight years of age)
- Native American and Inuit peoples seem to be at higher risk of flu 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 should check with their child's pediatrician first.
Where to Get Vaccinated
It depends on your coverage and the location.
Medical Benefit Coverage
To find a participating provider inside or outside Massachusetts, members can use our Find a Doctor tool or contact Member Service at the number on the front of your ID card.
To find a limited services clinic, after choosing the appropriate prefix and clicking on the Find Providers button, enter your service area and check the box next to the special category Retail Health.
Most Indemnity plan members have full coverage for flu shots when given by a participating provider. This includes approved flu shot clinics in retail and public settings.
Pharmacy Benefit Coverage
To find an ESI-participating pharmacy, go to http://www.express-scripts.com. You will need to choose a user name and password or log on using existing information.
- Limited services clinics (e.g., MinuteClinics®' at CVS/pharmacy)
- Urgent care centers
- Member's worksite when using a vendor approved by Blue Cross Blue Shield of Massachusetts
- Primary care provider's office
- Nurse practitioner's office
- Specialist's office
- Certified nurse-midwife's office
- Skilled nursing facilities (when a member is receiving outpatient custodial services, such as physical therapy or occupational therapy)
- Home health care provider, such as a visiting nurse1
- Outpatient department of a hospital
- Public access clinics offered through many cities and towns
- Express Scripts, Inc. participating pharmacies administered by a pharmacist who is licensed to perform flu vaccinations (some states have restrictions in place around pharmacist administration of vaccines.) No prescription is required.
1. 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 a cost.
If your plan offers coverage outside of Massachusetts, in addition to getting a vaccine from the options in the table above, you can 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 FinderSM. After choosing the appropriate prefix and clicking on the Find Providers button, enter your service area and check the box next to the special category Retail Health.
- Call Member Service at the number on the front of your ID card.
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.
Members will not be reimbursed for flu shots performed by non-participating doctors or facilities.