Friday, September 29, 2023

Does Anthem Blue Cross Blue Shield Cover Flu Shots

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When Does Blue Cross Blue Shield Insurance Pay For Flu Shots

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From the U.S. Department of Health and Human Services :

Flu and other vaccines are required to be covered by your health insurance without charging a copayment or coinsurance. Be sure to check with your insurance company to find out if you must go to a specific facility to receive the vaccine. Some insurance plans may only cover vaccines given by your doctor or at a limited set of locations.

The second sentence of the above paragraph is important. In some cases, an insurer may be allowed to charge a copayment or coinsurance or apply your deductible if the flu shot is administered by an out-of-network provider or is administered at certain times of the year.

Check with your Blue Cross Blue Shield Medicare plan carrier to find out where you can receive a flu shot that will be free of any copayments, coinsurance or deductibles.

You may also use the CDC flu shot finder tool to locate doctors, clinics and pharmacies near you that are offering the flu shot. Again, check with your Blue Cross Blue Shield plan to confirm that any flu shot location is part of your plans network to ensure full coverage.

Its also worth noting that if you receive any additional services during the appointment, you may be billed a copayment or coinsurance for an office visit or be billed for those additional services or items.

More Information On Flu Shots

A flu shot is important in any year, but the COVID-19 pandemic has further highlighted the importance of vaccines.

The flu can be just as serious for some people and require hospitalization, said Blue Cross Blue Shield of Kansas City medical director Rebecca Gernon, MD, MPH. So we anticipate that the collision of influenza and coronavirus is going to be problematic.

Gernon also notes that many of the same conditions that make someone more vulnerable to developing serious symptoms of COVID-19, such as hypertension and diabetes, are the same conditions that can heighten ones flu risk.

Consult our complete guide to the 2021-2022 flu season for more information about this years flu and the vaccine.

If youre considering applying for a Blue Cross Blue Shield Medicare Advantage plan or switching Medicare Advantage plans, you can compare plan benefits, costs, network providers and more online by finding plans available where you live. You can also call to speak with a licensed insurance agent who can help you compare plans.

More Information About The Flu Shot

The CDC recommends that everyone age 6 months and older should receive a flu shot every year, with only rare exceptions. The flu shot is especially critical for those at a higher risk of severe complications from the flu, such as individuals who are 65 and over, have certain chronic conditions, are pregnant, are part of specific races or ethnic groups and more.

You can learn more about the 2021-2022 flu season and the flu shot itself in our complete guide to the flu vaccine.

You can compare Anthem Medicare Advantage plans online to find out how the plans available where you live cover the flu shot, and you can compare other plan benefits that may include things like prescription drug coverage, dental, hearing, vision and more. You can also call to speak with a licensed insurance agent to learn more.

Recommended Reading: What Can Treat The Flu

New Members Can Get Vaccines At Pharmacies

Effective immediately, members 18 years of age and older with pharmacy benefits can now go to a participating Express Scripts retail pharmacy to receive 11 different immunizations. Vaccines are covered with no cost share to the member and a prescription is not required. Previously, only the flu vaccine was available from a retail pharmacy.

The 11 vaccines are:

  • Polio
  • Shingles

In Massachusetts, the pharmacist must be registered and licensed to administer the vaccine. Since requirements vary in other states, members should contact their local pharmacy to confirm availability.

Your employees can continue to get their immunizations at their doctor’s office or at an outpatient clinic. The addition of the pharmacy option is intended to expand access to these preventive services. Employees should contact their pharmacy directly to confirm if a pharmacist is available to administer any of these vaccines.

This benefit applies to all Access Blue, HMO, PPO, POS, and indemnity plans with pharmacy benefits.

Plan Benefits For 2022 Anthem Mediblue Service

The High Costs of Skipping Your Flu Shot

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Anthem MediBlue Service H4909-021 is a 2022 Medicare Advantage Plan or Medicare Part-C plan by Anthem Blue Cross and Blue Shield available to residents in Missouri. This plan does not provide additional Medicare prescription drug coverage. The Anthem MediBlue Service has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $6,700 . This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,700 out of pocket. This can be a extremely nice safety net.

Anthem MediBlue Service is a Local PPO *. A preferred provider organization is a Medicare plan that has created contracts with a network of “preferred” providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

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Where Can You Get Your Shots And Vaccines

If you have health insurance, choosing an in-network provider or a retail clinic that participates in your insurance plan can help you keep costs lower. You can get shots from an out-of-network provider, but you may be asked to pay the full price.

If you have a CareFirst health insurance plan, learn more about what vaccines are covered in the Summary of Preventive Services or ask Member Services any questions you may have.

If you are a member of another health plan, or are comparing available benefits, ask your health insurer’s Member Services office what vaccines are covered with your health insurance.

Getting Shots And Vaccines With Your Health Insurance

Vaccines are important for protecting you from preventable diseases like measles, meningitis, and the flu. Vaccines prepare your immune system to fight diseases without making you sick, so that when you’re exposed to the real thing, you can save your days off of work for something more fun than lying in bed with a splitting headache and a burning throat.

Also Check: How To Give Flu Vaccine Injection

When Should I Get The Flu Shot

Early fall is the best time to get your flu shot. Getting vaccinated early is important, because the flu is highly contagious and spreads rapidly.

Getting the shot before the flu season is in full force gives the body a chance to protect itself. Peak months for the flu season in Michigan are November, December, January, February, March and April.

What’s True About The Flu

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Learn the facts about flu season

In the 2020-2021 flu season, more than 410,000 people were hospitalized for problems caused by seasonal flu.1 Reduce your risk: Get an annual flu shot.

Many Blue Cross and Blue Shield of North Carolina members can get a flu shot at no extra cost.2 Check your preventive care benefits for your coverage and if any copay, deductible or coinsurance applies.

You can get a flu shot at these locations:

Worksite Clinic3

Some members can get a flu shot where they work. Many employers have worksite flu shot clinics at no cost to the member. Members of a group plan should check with their Human Resources or benefits department to learn more.

In-network pharmacists

Members can go to an in-network, immunizing pharmacist or MinuteClinic to get a flu shot. Some North Carolina pharmacists have contracted with Blue Cross NC to give flu shots. North Carolina immunizing pharmacists can give flu shots to those ages 10 and up. Some members may pay a copay, deductible or coinsurance, depending on their specific benefits.

  • To find in-network pharmacists, visit Find a doctor and verify the ZIP code for your search. Begin typing “Pharmacist” into the search box and under Specialties, select “Pharmacist “.

  • To find a participating MinuteClinic, begin typing “Convenience Care Centers” and select Convenience Care Centers Convenience Care .


  • The State Health Plan
  • FEP plans
  • Medicare Part D plans

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Does Anthem Cover Flu Shots

  • Anthem Medicare Advantage plans cover flu shots because they’re also covered by Original Medicare . You may be able to find Anthem Medicare plans that include prescription drug coverage, vaccinations, dental, hearing, vision, transportation and more.

Many people will stop to ask themselves if their flu shot will be covered by their insurance before making an appointment. So does Anthem cover flu shots?

Anthem Blue Cross Blue Shield is part of the Anthem family of brands and is a blue health plan brand. Medicare Advantage plans from Anthem Blue Cross Blue Shield, or simply Anthem for short, do indeed cover flu shots.

In fact, all health insurers are bound by a rule in the Affordable Care Act that requires health insurance plans to cover all federally recommended vaccines in full, when certain criteria are met. That means no copayment, coinsurance or deductible is charged to the patient. And among those federally recommended vaccines is the flu shot.

Anthem Medicare Advantage plans also cover an annual flu shot because its also covered by Medicare Part B. All Medicare Advantage plans including those offered by Anthem and its affiliate companies are required to cover everything that Original Medicare covers.

You can use the online Anthem flu shot finder tool to locate a facility near you offering flu shots covered by Anthem.

What Do I Need To Know About Flu Shots

Who is this for?

Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. If you’re a Medicare member, please visit our Medicare flu and pneumonia shots page to learn more.

There’s never been a more important time to get your flu shot. You can learn about it here. You might also want to know the symptoms of the flu versus COVID-19.

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Anthem Blue Cross And Blue Shield Announces No

INDIANAPOLIS—-As part of its mission to improve lives and communities across Indiana, Anthem Blue Cross and Blue Shield will sponsor more than 30 no-cost flu clinics this month at sites in Indianapolis, Fort Wayne, Evansville and Gary.

Getting the flu shot this year is more important than ever, said Dr. Julie Keck, Anthem Blue Cross and Blue Shield Medical Director. Getting the flu weakens the bodys defenses making us more vulnerable to COVID-19. A flu shot can help decrease the risk of becoming sick with the flu by as much as 60 percent and is also a way to protect those around you including young children, older adults and those with chronic health conditions.

Flu shots are available to anyone in the community at no cost. You do not have to be insured or an Anthem member, but if you do have insurance, bring your insurance card. Most of these events are for ages 11 and up, but restrictions may apply at certain events. All CDC and local health department protocols will be followed, including social distancing and face masks.

Pre-registration helps ensure that enough shots will be available, however, walk-ins are welcome. To register and find out more about each event, visit

Media interviews with Anthem clinical staff available upon request.

Flu clinics will take place at the following locations:


When Do Anthem Medicare Advantage Plans Pay For Flu Shots

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Medicare Part B covers one flu shot annually. And if the provider administering the shot accepts Medicare assignment, there is no charge to the beneficiary. Medicare Advantage plans are required by law to provide the same coverage as Medicare Part A and Part B.

If you have an Anthem Medicare Advantage plan, your flu shot will be covered, and you should have an opportunity to pay nothing out of pocket if you meet certain restrictions put forth by your plan. You may need to visit an in-network provider to receive full coverage of your flu shot, and you may have to pay higher out-of-pocket costs if you get your flu shot from an out-of-network provider or pharmacy.

Its important to note though that each individual insurer retains a little bit of wiggle room within those federal guidelines.

  • For instance, an insurer may require that the flu shot be administered by an in-network provider. If the shot is received at an out-of-network location, the insurer may be allowed to charge a copayment or apply a deductible.
  • An insurer might only grant full coverage for a flu shot when received during an annual physical or wellness exam. If the shot is given outside of that appointment, you might incur charges.
  • Likewise, insurers may also be allowed to charge a copayment for an office visit or apply the costs to your deductible if any other services were rendered during the same appointment.

You may also log into your online Anthem account to review the terms of your coverage.

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Other Flu Shot Options

You may also be able to get a flu shot at your doctors office or at a health clinic, such as a convenience clinic at a retail pharmacy.

In such settings, coverage would be under your preventive care benefits and the terms of your specific health plan would apply. You may need to pay some out-of-pockets costs. For instance, you may need to pay a fee for administration of the vaccine.

Additionally, some employers sponsor annual flu vaccines. Check with your Human Resources department to find out if this is an option for you.

Are Flu Shots Covered By My Blue Cross Plan

If you have an HMO plan, your annual flu shot is free.

For many PPO members, getting an annual flu shot also comes at no cost. Heres how you can see:

  • Log in to your online account on and search for immunizations or

If youre not sure which type of plan you have, your ID card will tell you.

Can I get reimbursed for a flu shot?

Reimbursements for flu shots depend on what plan you have. If you have Non-Medicare Blue Preferred PPOSM, or if you’re a BCN member, you may be eligible for a flu shot reimbursement.

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Does Blue Cross Blue Shield Cover Flu Shots

  • Blue Cross Blue Shield Medicare Advantage plans cover flu shots, as they’re also covered by Original Medicare . Most BCBS Medicare plans include prescription drug coverage, which can help pay for other vaccinations and preventive health care.

Flu season gets everyone thinking about the flu shot, and in turn, about their insurance.

If youre a Blue Cross Blue Shield Medicare Advantage plan beneficiary, theres no need to worry. Your flu shot is covered.

In fact, the same holds true for members of any insurance carrier. Flu shots are protected by the Affordable Care Act and must be covered by every insurance plan. And because flu shots are covered by Original Medicare , then all Medicare Advantage plans such as the ones from Blue Cross Blue Shield must also cover flu shots.

Plan beneficiaries can receive a flu shot with no copayment or coinsurance, whether by receiving it from a participating network provider or by meeting certain other criteria.

How Much Do Vaccines And Shots Cost With Insurance

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Without health insurance, shots and vaccines are paid out-of-pocket. This means something like the shingles vaccine could cost you around $200 if you are uninsured.

With insurance, many preventive shots are covered, although you are still responsible for any copay or deductible your health plan has. The cost of vaccines and shots depends on two factors: the type of shot or vaccine, and your insurance coverage.

For Blue Cross Blue Shield plans offered by CareFirst, vaccinations are completely free. You will pay no out-of-pocket copayment or coinsurance, and you will not have to pay toward your deductible.

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About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on , check out our videos on and follow us on .

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.

How Much Do Flu Shots Cost With Blue Cross Blue Shield Medicare Plans

Medicare Part B covers one flu shot per year. And if the health care provider administering the shot accepts Medicare assignment, there is no copayment, coinsurance or applied deductible.

Blue Cross Medicare Advantage plans are required by law to cover all the preventive services that Medicare covers at no cost to the patient when the services are performed by an in-network provider.

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Protect Your Health With Vaccinations

Vaccines can prevent or reduce your risk of developing deadly diseases. For example, human papillomavirus , a virus that causes over 27,000 cancer cases per year, can be prevented by vaccination. Theyre remarkably effective and easy to get, too.

Adults should make sure theyre up to date on all their vaccinations. Some shots may remain effective your entire life, others need to be administered multiple times throughout your lifetime.

The fluThousands of Americans die every year from the flu and flu-related illnesses. The Centers for Disease Control recommends everyone 6 months and older get a yearly flu shot. Good news for those with egg allergies: the flu vaccine is no longer made with eggs as of 2020.

The flu is not just a single virus, its multiple strains that change every year. Thats why its important you get the latest flu vaccine annually. It will protect you against most strainsif you do get sick, your symptoms will be less severe and youll recover faster.

Common types of adult vaccinationsYoure given a series of vaccinations as a child, but your immunity can fade over time and new diseases can develop. The Advisory Committee on Immunization Practices released a recommended adult immunization schedule that can give you a good idea of what vaccinations you may need. Heres what they recommend:

  • Flu, one dose annually

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