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Insurance Insights

Seasonal Flu and H1N1 Flu Vaccine

There is a significant amount of information in the media regarding the coming availability of the H1N1 (swine) flu vaccine as well as efforts at various institutions and throughout many communities to provide both seasonal flu and H1N1 flu vaccinations.  The following information explains how UT SELECT members will be billed when receiving either a seasonal flu vaccine or H1N1 flu vaccine from a BCBS network provider. 

It is our understanding that the H1N1 vaccine will become available in early – mid October.  The H1N1 vaccine is being provided at no cost by the U.S. government; however, there is a charge for the administration of the vaccine.  If a UT SELECT member receives the H1N1 vaccine from a BCBS provider, the member will pay for the cost of the administration of the vaccine, up to the cost of the office visit co-payment.  Because the cost of the administration of the H1N1 vaccine ranges from approximately $16-$22, the UT SELECT member will generally pay an amount less than the co-payment amount.  However, if other services are rendered while the UT SELECT member is receiving the H1N1 vaccine, then the visit will be billed as any other office visit and the full co-payment will be applied.  

Because there is not a U.S. government paid program for the seasonal flu vaccine, the billing for this vaccine will be handled the same as in previous years.  When a UT SELECT member seeks services from a BCBS provider, the seasonal flu vaccine will be billed as a regular office visit and the full co-payment will be applied.

Finally, flu shots are an eligible UT Flex expense.

We hope this information is useful for you as we move into the flu season.  


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