Check coverage for COVID-19 vaccines for Blue Cross commercial members, starting April 1

During the public health emergency, Blue Cross Blue Shield of Michigan has been covering COVID-19 vaccine administration for some Blue Cross commercial members who are enrolled in certain groups that are exempt from the Patient Protection and Affordable Care Act.

Effective April 1, 2023, these groups will revert to their pre-pandemic vaccine coverage, unless the group requested otherwise. As a result, these members may have cost sharing or may not have vaccine coverage.

Health care providers should check each Blue Cross commercial member’s eligibility and benefits to determine whether COVID-19 vaccines are a covered benefit.

When the public health emergency ends, all Blue Cross and BCN groups and members that are covered by PPACA will continue to have COVID-19 vaccine coverage with no cost sharing when administered by in-network providers or at in network pharmacies.

Note: When the government-purchased supply of the COVID-19 vaccine product runs out, providers should bill the member’s health plan for both administration and the vaccine product. We’ll process claims based on members’ immunization benefits.

Let your staff know they can check member eligibility and benefits for vaccines by following these steps:

1. Log in to our provider portal (availity.com).*
2. Click on Patient Registration in the menu bar and then click on Eligibility and Benefits Inquiry.
3. Enter the necessary information in the Payer section and the Provider Information section.
4. In the Service Information section, enter Immunizations in the Benefit/Service Type field.
5. Enter the patient ID in the Patient Information section.
6. Click on Search.
7. Select the tile for the appropriate member and click on Submit.
8. Do one of the following:
   
   

   If…	Then…
   There is a Benefit Explainer button near the top of the screen	Click on the Benefit Explainer button. Tip: If Benefit Explainer doesn’t open, you’ll need to allow Availity® to open pop-ups. In Benefit Explainer, click on the Search button. Press CTRL+F. Search on Preventive Immunizations.
   There isn’t a Benefit Explainer button near the top of the screen	Click on the Coverage and Benefits tab. Look in the Immunizations section.

*Blue Cross Blue Shield of Michigan doesn’t own or control this website.

Availity is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal services.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.