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H1N1 flu information

H1N1 and you

A message from Thomas Simmer, M.D., senior vice president, Health Care Value and Provider Affiliation and Chief Medical Officer, Blue Cross Blue Shield of Michigan, and Marc Keshishian, M.D., senior vice president, Chief Medical Officer, Blue Care Network.
 


On Oct. 24, President Barack Obama declared the H1N1 influenza (formerly referred to as swine flu), a national emergency.
 

The Michigan Blues are doing what we can to keep Michigan as healthy as possible and stay ahead of the pandemic.
 

Blue Cross Blue Shield of Michigan and Blue Care Network will cover the cost of administering the H1N1 vaccine for members in fully-insured customer groups and individual coverage during the 2009-2010 flu season.
 

We are enabling larger self-funded groups whose benefit plans are customized to add coverage for H1N1 vaccine administration. Normal copayments and deductibles will apply when applicable. If you have questions about your coverage, check with your employer's or group's benefits administrator.
 

The federal government will provide the H1N1 vaccine at no cost, which is why Blues coverage focuses on the administration cost of the H1N1 flu vaccine.
 

The Blues based its decision to cover the H1N1 vaccine on guidance from the U.S. Centers for Disease Control and Prevention and a call for health plans to provide the coverage. CDC predicts widespread H1N1 outbreaks this fall and winter and recommends prioritizing the administration of the H1N1 vaccine for these five populations:
 

  • Pregnant women
  • People who live with or care for children younger than six months old
  • Health care and emergency services personnel
  • Children and young adults from six months to 24 years old
  • People ages 25 to 64 with chronic medical conditions that increase their risk of complications from influenza infection

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If you or any family members fall within these categories, we urge you to contact your family physician, local health department or Michigan participating pharmacy for more information about getting a vaccine.
 

The Michigan Blues continue to regularly interact with the Michigan Department of Community Health, which has been providing updates on the situation.
 

Additional information about H1N1 is available in this FAQ.
 

Michigan Blues members who live out of state can find information here.
 


Overview

How can you tell the difference between the H1N1 influenza virus (formerly referred to as swine flu) and the regular seasonal flu?
 

According to the Centers for Disease Control and Prevention, all types of flu can cause fever, coughing, sore throat, a runny or stuffy nose, headaches, body aches, chills and fatigue.
 

Those suffering from H1N1 may experience all of the above symptoms more severely, in addition to nausea, vomiting and diarrhea.
 

Taking care of yourself if you get sick

If you are diagnosed with the H1N1 flu, you should stay home for at least 24 hours after your fever is gone unless you're seeking medical care or need to run other essential errands.
 

The CDC also recommends that you:
 

  • Avoid close contact with others, especially those who might easily get the flu, such as people age 65 years and older, people of any age with chronic medical conditions (such as asthma, diabetes or heart disease), pregnant women, young children and infants.
  • Clean hands with soap and water or an alcohol-based hand rub often, especially after using tissues or coughing and sneezing into your hands.
  • Cover coughs and sneezes.
  • Wear a facemask when sharing common spaces with other household members to help prevent spreading the virus to others.
  • Drink clear fluids such as water, broth, sports drinks or electrolyte beverages made for infants to prevent becoming dehydrated.
  • Get plenty of rest.

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You should seek medical attention immediately if you experience any of these symptoms:
 

  • Difficulty breathing or chest pain
  • Purple or blue discoloration of your lips
  • Vomiting and unable to keep liquids down
  • Signs of dehydration, such as feeling dizzy when standing or being unable to urinate

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Caring for a sick person at home

If you are the caregiver for someone who has H1N1 flu, you should protect yourself and others in the household.
 

  • Avoid being face-to-face with the sick person. When holding small children who are sick, place their chin on your shoulder so they will not cough in your face.
  • If you're unable to avoid close contact with a sick person, consider wearing a face mask or respirator, if available and tolerable.
  • Ask the person's health care provider about any special care that might be needed, especially if the person is pregnant or has a health condition such as diabetes, heart disease, asthma or emphysema.
  • Ask the patient's health care provider whether the patient or you, as the caregiver, should take antiviral medications such as oseltamivir (Tamiflu®) or zanamivir (Relenza®).
  • Keep the sick person away from other people as much as possible, especially others who are at high risk of complications from influenza.
  • Make sure everyone in the household cleans their hands often, using soap and water or an alcohol-based hand rub.

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Seek immediate medical care for the patient if they have any of these symptoms:
 

  • Difficulty breathing or chest pain
  • Purple or blue discoloration of the lips
  • Vomiting and unable to keep liquids down
  • Signs of dehydration, such as feeling dizzy when standing, being unable to urinate, or (in infants) crying without shedding tears
  • Seizures (for example, uncontrolled convulsions), or if they are less responsive than normal or become confused

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Frequently Asked Questions

General questions about H1N1 flu

Frequently Asked Questions

Are the Michigan Blues prepared for health emergencies like flu pandemics?

Blue Cross Blue Shield of Michigan and Blue Care Network have taken steps that will help us best serve our communities in the event of a health emergency. We are following guidelines from the Centers for Disease Control and Prevention and Michigan Department of Community Health.
 

What will the Michigan Blues pay to administer the H1N1 vaccine?

The federal government will provide the vaccine at no charge for this year only. The Michigan Blues will pay for the shot's administration if the group has not opted out of this coverage.
 

Will members have a copayment, coinsurance or deductible?

BCBSM copayments, coinsurance and deductibles vary depending on the contract and riders involved. BCN copayments, coinsurance and deductibles will apply according to the member's benefits.
 

Will the Blues pay for multiple H1N1 shots if the vaccine requires more than one shot?

Yes, we will pay for multiple shots if the member's group has not opted out of this coverage.
 

Will the Blues cover the cost of administering the H1N1 vaccine for those with individual coverage?

Yes, the Blues will cover the cost of administering the H1N1 vaccine to members with individual coverage.
 

Will the Blues cover the cost of administering the H1N1 vaccine for those with Medigap or supplemental coverage?

Yes, Medicare plans will cover the H1N1 vaccinations. Although Medicare typically only pays for one vaccination per year, if more than one vaccination is medically necessary, they will pay for it.
 

Will the Blues cover the cost of administering the H1N1 vaccine for those with Medicare Advantage?

Yes, Medicare plans will cover the H1N1 vaccinations. Although Medicare typically only pays for one vaccination per year, if more than one vaccination is medically necessary, they will pay for it.
 

If the H1N1 vaccine is administered in a physician's office will it be covered?

Yes, if the member's group hasn't opted out of this coverage, these services will be covered.
 

If the H1N1 vaccine is administered at a hospital or in a hospital outpatient setting, will it be covered?

Yes, this will be payable in the inpatient and outpatient setting if the member's group hasn't opted out of this coverage.
 

If the H1N1 vaccine is administered at a public health clinic will it be covered?

Yes, it will be payable at public health clinics for members if their group hasn't opted out of this coverage.
 

If the vaccine is administered by a pharmacy will it be covered?

We have instituted a new process that enables pharmacies to submit claims for administration of flu shots for members covered for these services. It is best to call ahead to the pharmacy to determine if they have the vaccine and whether they will bill BCBSM or BCN for the administration of the vaccine.
 

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General questions about H1N1 flu

What is H1N1?

H1N1 (sometimes called "swine flu") is a new influenza virus causing illness in people. This new virus was first detected in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) signaled that a pandemic of H1N1 flu was under way.
 

Why is the H1N1 virus sometimes called "swine flu?"

This virus was originally referred to as "swine flu" because laboratory testing showed that many of the genes in the new virus were very similar to influenza viruses that normally occur in pigs (swine) in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs.
 

How does the virus spread?

H1N1 virus is thought to occur in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something — such as a surface or object — with flu viruses on it, and then touching their mouth or nose.
 

What are the signs and symptoms of this virus in people?

The symptoms of H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea. People may be infected with the flu, including H1N1, and have respiratory symptoms without a fever.
 

Severe illnesses and deaths have occurred as a result of illness associated with this virus.
 

How severe is illness associated with the H1N1 flu virus?

Illness has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths have occurred.
 

About 70 percent of people who have been hospitalized with this virus have had one or more medical conditions previously recognized as placing people at “high risk” of serious seasonal flu-related complications. This includes pregnancy, diabetes, heart disease, asthma and kidney disease.
 

Young children are also at high risk of serious complications from H1N1, just as they are from seasonal flu. And while people 65 and older are the least likely to be infected with H1N1, if they get sick, they are also at "high risk" of developing serious complications from their illness.
 

CDC laboratory studies have shown that no children and very few adults younger than 60 years old have existing antibodies to H1N1; however, about one-third of adults older than 60 may have antibodies against this virus. It is unknown how much, if any, protection may be afforded against H1N1 flu by any existing antibody.
 

How does H1N1 flu compare to seasonal flu in terms of its severity and infection rates?

With seasonal flu, we know that seasons vary in terms of timing, duration and severity. Seasonal influenza can cause mild to severe illness, and at times can lead to death. On average, each year in the United States, 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than five years old. Over 90 percent of deaths and about 60 percent of hospitalizations occur in people older than 65.
 

How long can an infected person spread this virus to others?

People infected with seasonal and H1N1 flu may be able to infect others from one day before getting sick to five to seven days after. This can be longer in some people, especially children and people with weakened immune systems and in people infected with the new H1N1 virus.
 

Are there medicines to treat H1N1 infection?

Yes. Your doctor may prescribe antiviral drugs.These drugs can make you better faster and may also prevent serious complications. This flu season, antiviral drugs are being used mainly to treat people who are very sick, such as people who need to be hospitalized, and to treat sick people who are more likely to get serious flu complications. Your health care provider will decide whether antiviral drugs are needed to treat your illness. Remember, most people with H1N1 have had mild illness and have not needed medical care or antiviral drugs and the same is true of seasonal flu.
 

How long can the influenza virus remain contagious on objects (such as books and doorknobs)?

Studies have shown that influenza virus can survive on most hard surfaces and can infect a person for two to eight hours after being deposited on the surface.
 

What kills influenza virus?

Influenza virus is destroyed by heat (167-212 degrees F, 75-100 degrees C). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. Facilities Support Services and Environmental Health and Safety carefully reviews the cleaning products used in BCBSM and BCN facilities to ensure employee health and safety, as well as environmental sustainability.
 

What surfaces are most likely to be sources of contamination?

Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.
 

How should waste disposal be handled to prevent the spread of influenza virus?

To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. People should wash their hands with soap and water after touching used tissues and similar waste.
 

Eating utensils should be washed either in a dishwasher or by hand with water and soap.
 

Can I get infected with H1N1 virus from eating or preparing pork?

No. H1N1 viruses are not spread by food. You cannot get infected with HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.
 

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BCBSM and BCN compiled this document using background from the Centers for Disease Control and flu.gov. This information is subject to change based on new developments.
 


Prevention

Practice good health habits

Take the time to wash your hands frequently. Here’s how:

  1. Rub vigorously for 15 to 20 seconds — about the time it takes to sing “Happy Birthday” twice.
  2. Rinse and pat your hands dry with a paper towel.
  3. If possible, turn off the faucet with a clean paper towel.

Get in the habit of washing your hands on a regular basis, but especially:

  • Before
    • Preparing food
    • Eating
    • Putting in or removing your contacts
    • Touching a sick person
    • Treating a cut or wound
  • After
    • Using the bathroom
    • Touching dirty surfaces or things that may carry germs, including raw food, diapers, animals and trash
    • Being around a sick person
    • Blowing your nose, coughing or sneezing

Use an alcohol-based hand sanitizer if soap and water are not available.
 

Tips for staying healthy at work

The Centers for Disease Control suggest other tips for staying healthy at work:

  1. Avoid touching your nose, mouth, and eyes. Germs spread this way.
  2. Cover your coughs and sneezes with a tissue, or cough and sneeze into your elbow. Dispose of tissues in no-touch trash receptacles.
  3. Keep frequently touched common surfaces clean, such as telephones, computer keyboards, doorknobs, etc.
  4. Don't use other workers’ phones, desks, offices, or other work tools and equipment. If you must use it, clean it first.
  5. Don't spread the flu! If you are sick with flu-like illness, stay home.
  6. Maintain a healthy lifestyle through rest, diet, and exercise.
  7. Learn more. Visit flu.gov or contact CDC 24 hours a day, 7 days a week at 1-800-CDC-INFO (232-4636)

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Preparedness

Prepare, don’t panic.
 

It’s great advice, whether you are coping with the spread of H1N1 or other public health issues.
 

The federal government offers free downloadable tools to help your family prepare for an emergency.
 

Here's one example:
 

http://www.flu.gov/professional/pdf/informationsheet.pdf
 

There's also helpful information available as to other preparedness steps you can take:
 

Help reduce the flu at work
 

More is available at pandemicflu.gov.
 


Resources

Here are some credible Web resources where you can read the latest information about H1N1 and the seasonal flu:


Members outside of Michigan

Blue Cross Blue Shield of Michigan members who live outside of Michigan can seek the H1N1 vaccine from a participating provider in their states. Please note that participating providers vary by state. As always, please contact your provider beforehand to determine their participating status. If you have any questions about your coverage, please call the number on the back of your Blues ID card.