888-765-5400H1N1 Vaccination and BCBSNC
To encourage members to get the H1N1 vaccine, BCBSNC will waive deductible and coinsurance payments for its fully-insured customers that do not have immunization/preventive benefits and will pay 100 percent of eligible charges for the administration of the H1N1 vaccine.
As with the seasonal flu vaccine, ASO groups are responsible for the claims costs associated with the H1N1 vaccines. ASO groups that don’t have immunization/preventive benefits can choose to cover the cost of the H1N1 vaccine administration at 100 percent of eligible charges for employees and their dependents. If you have an ASO group that may want to do this, please contact your BCBSNC representative.
Communication Plan
BCBSNC issued the attached press release Monday (10/5), and we expect to receive media coverage. We will also be mailing the attached letter to group administrators of fully-insured groups this week.
Key Points about the H1N1 Vaccine
- BCBSNC’s decision to cover the cost of the H1N1 vaccine for fully-insured members is based on guidance from the Centers for Disease Control (CDC) and Prevention’s Advisory Committee on Immunization Practices, which predicts widespread H1N1 outbreaks this fall and winter.
- To be fully protected against the seasonal and H1N1 flu, people should get both a seasonal and H1N1 vaccine. These may be given on the same day.
- BCBSNC also covers the seasonal flu vaccine; however, a copayment, deductible or coinsurance may apply for some members.
- Although the majority of the supply will be an injectable vaccine, there is also a nasal spray version being produced. BCBSNC’s decision to cover the costs associated the H1N1 vaccine for fully-insured members will also apply to coverage of the nasal spray. Note that the nasal spray vaccine supply will account for less than 15 percent of the total H1N1 supply.
- BCBSNC is working with Maxim Healthcare Services, our worksite flu clinic provider, to offer worksite H1N1 flu vaccine clinics once the H1N1 vaccine becomes available and priority groups (see bullets below) are vaccinated.
- Once the H1N1 vaccine is available, BCBSNC members may also go to their physician, in-network pharmacist, or a CVS Minute Clinic to get a covered H1N1 vaccine. Members are advised to contact their provider to ensure that the H1N1 vaccine is available.
- The Centers for Disease Control and Prevention has designated the following groups as priority groups for getting the H1N1 vaccine first:
- Pregnant women
- People who live with or provide care for infants less than 6 months of a
- Health care and emergency medical services personne
- Children and young adults ages 6 months to 24 year
- Adults ages 25 to 64 years with medical conditions that put them at higher risk for influenza-related complications
Plans for H1N1 Worksite Clinics via Maxim
BCBSNC is working with Maxim Healthcare Services, our worksite flu clinic provider, to offer worksite H1N1 flu vaccine clinics once the H1N1 vaccine becomes available and priority groups are vaccinated. We do not have an estimated timeframe for when this will occur.
Here’s what else we know so far about these clinics:
- Once the CDC or NC Division of Public Health announces the general public may now be given the H1N1 vaccine, we will send an email to the same groups that were sent the seasonal flu email.
- We expect the administration and communication plan for the H1N1 worksite clinics to be very similar to the plan for seasonal flu shots.
- At Maxim clinics, the H1N1 vaccine will be free-of-cost to all members and $15 for non-members.
- ASO groups will pay $12 per member for the H1N1 vaccine.
- At Maxim clinics, we will not administer the vaccine to children under the age of 10.
The above information is taken from a News Release from BCBSNC October 2009.
For more information on health insurance coverage in North Carolina and how to utilize My Member Services, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.
