Protection From The Flu
The seasonal flu vaccine is available at no cost to Aetna members who have benefits that cover preventive services.
The vaccine is available for adults and for children 6 months and older. Children aged 6 months through age 8 who have never had the vaccine or have only had one dose in their lifetimes should have two doses of the flu vaccine, with at least four weeks between doses.
The Flu Vaccine Helps Protect You And Your Family From The Flu
Millions of people get influenza every year. While it may be common, seasonal flu is a potentially serious disease. It can lead to hospitalization and even death, according to the Centers for Disease Control and Prevention .1 Thats why its recommended to get a flu vaccine every year to help protect yourself and your family.2 The flu vaccine can help:
- Weaken or prevent the flu
- Reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent during seasons when the flu vaccine viruses are similar to circulating flu viruses1
Here’s What To Know Before You Go
Putting off getting your flu shot or other vaccines because you don’t have time for a doctor’s appointment? The next time you pick up a few things at the drugstore or grocery store, consider updating your vaccinations at the pharmacy.
Pharmacists are trained in immunization technique and are well versed in how to administer shots, according to Carmen Catizone, D.Ph., executive director of the National Association of Boards of Pharmacy .
“In fact, today, more patients are receiving their vaccinations from pharmacists than other healthcare providers,” says Catizone.
CVS, Rite Aid, Walgreens, and other chains and some independent pharmacies offer more than the flu shotthey typically also administer other immunizations recommended by the Centers for Disease Control and Prevention , including vaccines against pneumonia, polio, shingles, Tdap , and varicella .
In addition, many also offer travel immunizations for meningitis, typhoid, yellow fever, and other diseases.
An added perk: CVS, Walgreens, and other chains offer loyalty programs that earn you reward points towards discounts on other store purchases. Sign up online or at the pharmacy counter.
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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.
Does Medicare Pay For Flu Shots At Walmart
Medicare Part B covers flu shots at Walmart, as long as you are enrolled in Medicare Part B and you havent already had a shot in the flu season in question flu season runs from November to April.
Walmart is Medicare-enrolled and bill Medicare the flu shot there will be no deductible or co-pay.
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Importance Of Flu Shots For Seniors
Americans are living longer than ever before. Eating well, staying active and working with your doctor to control any medical problems you might have will help you enjoy a healthy life well into your senior years. Still, aging takes a toll on your immune system making it less capable of fighting infections like the flu. As you get older, you’re more likely to catch the flu. You’re also more likely to develop serious problems like pneumonia if you come down with the flu. Americans 65 and older are more likely than any other age group to be hospitalized for the flu, and approximately nine out of 10 flu deaths in the U.S. occur in seniors, according to the Centers for Disease Control and Prevention .
Saving On Pharmacy Vaccinations
Just like at your doctors office, pharmacies that offer vaccinations will file with your insurance.
Many vaccinations wont cost you anything if you have a private insurance plan through your employer or that you purchased on a state marketplace. Under the Affordable Care Act, private plans are required to fully cover the cost of recommended vaccinations for adults and children as preventive medical care.
Unfortunately, Medicare doesnt do as good of a job of covering recommended immunizations. Only flu, pneumonia, and hepatitis B vaccines are fully covered under Medicare Part B. Other vaccinations are treated like prescription drugs and are covered under Medicare Part D or Advantage plans. That means youll be responsible for paying any co-pays and deductibles required by your prescription drug plan.
If youre paying out of pocket, shop around to find the lowest price. When we checked, we found the lowest prices without insurance at Costco. For example, Pneumovax pneumonia vaccine cost $110 at CVS and Target, but just $97 at Costco pharmacies. And the dual Hepatitis A and B vaccine costs $145 at CVS, $150 at Walgreens , and $93 at Costco.
Another option if you are uninsured or paying out of pocket is to check with statewide free health clinics and community health centers, which offer free or low-cost preventive care and low-cost vaccinations. Find a clinic near you.
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Which Vaccines Does Medicare Cover
Medicare covers most vaccines. Some are covered by Part B, and some are covered by Part D.
Getting the vaccines you need is one of the most important things you can do for your health and for the health of those around you. Vaccines are your first line of defense against a number of infectious diseases. If you dont get sick, then you cant infect your loved ones, your friends or others in your community.
Find Out How Medicare Pays For Flu Shots
Medicare is defined in 4 parts: A, B, C and D. The combinations of Medicare Parts A and B is known as the Original Medicare program. Medicare Part C is known as Medicare Advantage. Whether youre enrolled in the Original Medicare program or a Medicare Advantage plan, know that your flu shot is covered by Medicare.* The information below provides details about how Medicare covers the flu vaccine depending on the type of Medicare program youre enrolled in.
*The cost of the shot may be affected if the provider is out of your network.
Enrolled in an Original Medicare plan? Discover how your flu shot is covered.
Original Medicare is commonly known as traditional Medicare and is made up of 2 parts: Medicare Part A and Medicare Part B . This program is offered by the federal government and provides members with a flu shot without a deductible or copay. The flu vaccine must be given by a physician, pharmacist or healthcare provider who accepts Medicare. This means the healthcare provider has agreed to provide this service and accept payment from the Medicare program/plan at a set rate. It is best to call ahead to find out if Medicare pays for flu shots at your pharmacy.
Got a Medicare Advantage plan? Find out how your flu shot is covered.
Which Medicare Services Cover Flu Shots
Flu shots are covered under Original Medicare and Medicare Advantage, so long as your provider or pharmacy is one that accepts Medicare payment.
Because Medicare Advantage plans must offer at least the same coverage as Original Medicare, your Medicare Advantage plan also covers flu shots once a flu season. Private health plans may not require that you get a referral to receive the flu shot, but they may require that you receive the shot within your plans network of providers. Like Original Medicare, Medicare Advantage plans cover the full cost of the flu shot. Overall out-of-pocket costs such as premiums and deductibles may vary for these plans, but the deductible does not apply in this situation, if the plan has one.
Does Medicare Cover Flu Shots
Medicare Part B, one of the two parts of Original Medicare, covers 100% of the costs of seasonal flu shots once a year during the fall or winter. The Part B deductible does not apply to this service, so Medicare covers the shot as long as you are eligible for and enrolled in Original Medicare. As long as your doctor or healthcare provider accepts Medicare assignment, flu shots are fully covered. Providers may not charge you more than the Medicare approved amount. If you receive the shot from a provider that does not accept assignment, then you may be responsible for additional fees for the doctors services but not for the shot itself.
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The Cost Of A Flu Shot At Major Pharmacies
- American Indian
- Alaska Native
Vaccines provided by VFC are free, but there may be an administration or office-visit fee. Contact your local VFC coordinator to find doctors who work with the program. Or, you can visit a public health clinic, federally qualified health center, or rural health clinic to get vaccines through VFC.
Who Should Get The Flu Shot
The CDC recommends that anyone over the age of six months should get a flu shot.
Some people have a higher risk for developing flu-related complications. If you have chronic conditions such as asthma, heart disease, diabetes or chronic kidney disease you should make getting the flu shot a high priority. The same is true for people who are 65 and older.
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Can I Get More Than One Vaccine During The Same Visit
If you need more than one vaccine, talk to your doctor or pharmacist about whether you should get them all in one visit, or space them out.
Its very common to bundle immunizations for children, and there are many cases where adults may get two vaccines at the same time.
The agency has also given the green light for people to receive a COVID-19 vaccine, including a booster shot , and the flu shot during the same visit.
In fact, the CDC says that the COVID-19 vaccine can be given without regard to the timing of any other vaccine.
What’s True About The Flu
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:
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.
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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What Vaccines Can A Pharmacist Give
Along with the COVID-19 shot and the flu shot, most pharmacists can administer vaccines to protect against:
In addition to vaccinations, other kinds of injections may be available. Some pharmacies, for example, offer the birth control shot and vitamin B12 injections to patients over 18 with a prescription from a doctor.
How Much Do Flu Shots Cost At Pharmacies
If youre paying out of pocket, you may want to visit a pharmacy to get your flu vaccine. Many offer appointments or walk-in flu-vaccine clinics. Heres a sample of various flu vaccines and their prices at four common pharmacies. Prices and vaccine offerings may vary by location:
|Pricing reflects Costco Member Prescription Program Discount Card, which may vary by location.|
Pricing reflects Costco Member Prescription Program Discount Card, which may vary by location.
If you must pay out of pocket for your flu vaccine, GoodRx may help you save money at participating pharmacies in all 50 states and Puerto Rico. The GoodRx Flu Vaccine Program includes the vaccine administration fee, and prices are as low as $25 for those under age 65 and $62 for those over age 65.
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Where Can I Go To Get Vaccinations
Vaccines are offered at drugstore chains, including CVS, Rite Aid, and Walgreens warehouse clubs like Costco and Sams Club and many independent pharmacies.
The Federal Retail Pharmacy Program for COVID-19 Vaccination has 21 national pharmacy partners and independent pharmacy networks to help increase access to the vaccine. A list of the partners can be found on the CDC website.
Are Flu Shots Free For Seniors
For seniors who have Medicare Part B, C, or D, one flu shot per year is free. Medicare will cover two flu shots if a second shot is deemed medically necessary by a healthcare provider. Some seniors, however, do not have these Medicare plans and might need to pay out of pocket for the flu shot.
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Does Medicare Cover Pneumonia Shots At Walgreens
Medicare Part B does cover the pneumococcal vaccine at Walgreens.
As long as you are enrolled in Medicare Part B, you can get the Pneumococcal vaccine without deductible or co-pay.
Walgreens gives the two types of pneumococcal vaccine
PPSV23 pneumococcal polysaccharide vaccine protects against 23 types of pneumonia bacteria
PCV13 pneumococcal conjugate vaccine protects against 13 types of pneumonia bacteria, including those most likely to cause serious disease.
You can read more about pneumonia shots at Walgreens here.
You just need to take along your insurance information, and a photo ID.
You can make an appointment at a Walgreens near you on this page of their site here.
Does Medicare Pay For Flu Shots At A Pharmacy
Medicare Part B will cover one flu shot per season, at pharmacies, if they are Medicare-enrolled and accept assignment.
There are systems with supervising physicians at pharmacies, and standing orders, which may vary by state, which have been designed to increase immunization against the flu and pneumonia viruses.
In some states, the pharmacist themselves can give shots, but this varies by state.
As long as the pharmacy is a Medicare-enrolled pharmacy which accepts assignment.
With the flu and the pneumonia vaccines you do not have to pay a deductible, and if the pharmacy accepts assignment you do not have to pay any coinsurance.
The pharmacy if it is Medicare-enrolled should bill Medicare directly.
Dont forget to ask the pharmacist to have the information on the vaccination forwarded to your primary care doctor to have your records updated.
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Do You Need A Flu Shot This Year
According to the Centers for Disease Control and Prevention , people over the age of 65 are at a very high risk of developing dangerous complications from the flu.1 If you are over 65 years old and/or have autoimmune issues , getting your Medicare-covered flu vaccine is your best defense at protecting you from the flu or lessening the effects of it.
Why Should The Elderly Get Flu Shots
The following text makes a compelling argument for the elderly to get immunized against the flu.
Each year in the United States, 9 out of 10 flu-related deaths and 6 out of 10 flu-related hospital stays occur among people aged 65+. An annual flu shot is one of the best preventive measures to help protect against the flu. The shot is available in both a regular strength dose and a high dose that provides extra immunity, which is often recommended for older adults.
The text is from the NCOA Center for Benefits access Vaccines: What Medicare pays forwhich you can read here.
The immune system is less able to defend your body against infections and viruses the older you get.
Unfortunately, this also means the older a person is, the more likely they are to catch the flu when they are to come into contact with the virus.
On top of this, the older you are, the more likely you are to develop serious complications from the flu, such as pneumonia.
The flu is an even greater risk for over 65s who have underlying health conditions causing serious complications, such as pneumonia.
The underlying health conditions which put a person at increased risk include
- a compromised immune system
Cancer treatment, HIV/AIDS, steroids and other forms of anti-inflammatory treatments can compromise the immune system, making it vulnerable to the flu virus.
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Vaccines Covered By Medicare Part D
Medicare Part D covers all commercially available vaccines needed to prevent illness. You can get Part D coverage through a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes drug coverage.
Vaccines covered by Part D include the following:
- Shingles vaccine: One-time vaccine given in two shots over two to six months
- Tdap vaccine : One shot if youve never been vaccinated, and a booster every ten years
- Other vaccines covered: Vaccines that are “reasonable and necessary” to prevent illness and are not covered by Part B
Part D may also cover vaccines you may need if you are traveling internationally. Talk with your doctor about your travel plans and ask what vaccines are recommended.