Blue Cross Blue Shield of Michigan and Blue Care Network announce interim policy to cover H1N1 vaccine administration for fully-insured groups during 2009-2010 flu season

BCBSM and BCN also will begin reimbursing pharmacies for flu shots beginning October 1

September 11, 2009

DETROIT - Blue Cross Blue Shield of Michigan and Blue Care Network today announced an interim policy to automatically cover the cost of administration of the H1N1 (Swine Flu) vaccine for members in their fully-insured customer groups and individual coverage during the 2009-2010 flu season — unless a group chooses to opt out of the coverage.

The Blues also announced that it will enable larger self-funded groups whose benefit plans are customized to add coverage for the H1N1 administration upon request. Normal copays and deductibles would apply if the member has them.

The coverage is dependent on FDA approval and when the new vaccine becomes available to the general public. The federal government has indicated it will provide the H1N1 vaccine at no cost, which is why Blues coverage focuses on the administration of the vaccine shots.

In another move to broaden access to flu vaccines, BCBSM and BCN for the first time will cover flu shots administered by pharmacies — including the H1N1 vaccine, if a member with flu vaccine coverage opts to receive the vaccine through a pharmacy. This will eliminate the need for patients with flu vaccine coverage to seek reimbursement from BCBSM for a vaccination from a pharmacy.

"Blue Cross is doing what we can to keep Michigan as healthy as possible ahead of the pandemic's return this flu season," said Daniel J. Loepp, BCBSM president and CEO. "It's important that we act now to inoculate people most at risk and prevent as best we can the impact of H1N1 to our communities and health system."

The U.S. Centers for Disease Control and Prevention state that the H1N1 vaccine should not replace the seasonal flu vaccine. The seasonal flu vaccine and the H1N1 vaccine may be administered on the same day, according to the CDC.

BCBSM and BCN's decision to cover the H1N1 vaccine is based on guidance from the CDC's Advisory Committee on Immunization Practices (ACIP). ACIP predicts widespread H1N1 outbreaks this fall and winter, and recommends prioritizing the H1N1 vaccine for these five populations: pregnant women; people who live with or care for children younger than six months of age; health care and emergency services personnel; children and young adults from 6 months to 24 years old; and people ages 25–64 with chronic medical conditions that increase their risk of complications from influenza infection.

BCBSM or BCN members can check their flu vaccine coverage benefits by contacting their group benefit administrator.

Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to 4.7 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including: Traditional Blue Cross Blue Shield; Blue Preferred®, Community Blue℠ and Healthy Blue Incentives℠ PPOs; Blue Care Network HMO; BCN's Healthy Blue Living℠; Flexible Blue℠ plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue℠products in the under-age-65 individual market. BCBSM also offers dental, vision and hearing plans. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.