Does Blue Cross Blue Shield Cover Flu Shots?
- Blue Cross Blue Shield Medicare Advantage (Part C) plans cover flu shots, as they're also covered by Original Medicare (Parts A and B). 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 you’re a Blue Cross Blue Shield (BCBS) Medicare Advantage plan beneficiary, there’s 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 (ACA) and must be covered by every insurance plan. And because flu shots are covered by Original Medicare (Part A and Part B), then all Medicare Advantage (Medicare Part C) 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.
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When Does Blue Cross Blue Shield Insurance Pay for Flu Shots?
From the U.S. Department of Health and Human Services (HHS):
“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 plan’s network to ensure full coverage.
It’s 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.
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.
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 (as COVID-19) 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 one’s flu risk.
Consult our complete guide to the 2024 flu season for more information about this year’s flu and the vaccine.
If you’re 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.
