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December 2023
Blue Cross, BCN covering additional vaccines
Blue Cross Blue Shield of Michigan and Blue Care Network want to increase access to vaccines and decrease the risk of vaccine-preventable disease outbreaks. As a result, we’ve added the following vaccine to our list of vaccines covered under the pharmacy benefit:
Vaccine |
Common name and abbreviation |
Effective date |
Beyfortus™ |
Respiratory syncytial virus — RSV |
Sept. 28, 2023 |
The following lists all the vaccines covered under eligible members’ prescription drug plans. Most Blue Cross and BCN commercial (non-Medicare) members with prescription drug coverage are eligible. If a member meets the coverage criteria, the vaccine is covered with no cost sharing.
Vaccines that have an age requirement
Vaccine |
Common name and abbreviation |
Age Requirement |
Gardasil 9® |
Human papillomavirus vaccine — HPV |
9 to 45 years old |
Influenza virus |
Influenza vaccine — flu |
Under 9: 2 vaccines per 180 days
9 and older: 1 vaccine per 180 days |
Prevnar 13® |
Pneumococcal 13 — valent conjugate vaccine |
65 and older |
Vaccines that have no age requirement
Plan |
How it works |
Dengvaxia® |
Dengue vaccine — DEN4CYD |
Daptacel®
Infanrix®
|
Diphtheria, tetanus, and acellular pertussis vaccine — DTaP |
Diphtheria and Tetanus Toxoids |
Diphtheria, tetanus vaccine — DT |
Kinrix®
Quadracel®
|
DTap and inactivated poliovirus vaccine — DTaP-IPV |
Pediarix® |
DTaP, hepatitis B, and inactivated poliovirus vaccine — DTaP-HepB-IPV |
Vaxelis®
|
DTaP, inactivated poliovirus, Haemophilus influenzae type b, and hepatitis B vaccine — DTaP-IPV-Hib-HepB |
ActHIB®
Hiberix®
PedvaxHIB®
|
Haemophilus influenzae type b vaccine — Hib |
Havrix®
Vaqta®
|
Hepatitis A — HepA |
Engerix-B®
Heplisav-B®
PreHevbrio™
Recombivax HB®
|
Hepatitis B — HepB |
Twinrix®
|
Hepatitis A & B — HepA-HEPB |
M-M-R II®
Priorix®
|
Measles, mumps, rubella vaccine — MMR |
ProQuad® |
Measles, mumps, rubella and varicella vaccine — MMRV |
Menveo®
|
Meningococcal serogroups A, C, W, Y vaccine — MenACWY-CRM |
Menactra® |
Meningococcal serogroups A, C, W, Y vaccine — MenACWY-D |
MenQuadfi® |
Meningococcal serogroups A, C, W, Y vaccine — MenACWY-TT |
Bexsero® |
Meningococcal serogroup B vaccine — MenB-4C |
Trumenba® |
Meningococcal serogroup B vaccine — MenB-FHbp |
Vaxneuvance™ |
Pneumococcal 15-valent conjugate vaccine — PCV15 |
Prevnar 20™ |
Pneumococcal 20-valent conjugate vaccine — PCV20 |
Pneumovax 23® |
Pneumococcal 23-valent polysaccharide vaccine — PPSV23 |
IPOL® |
Poliovirus — IPV |
Arexvy™
Abrysvo™
Beyfortus™
|
Respiratory syncytial virus — RSV |
Rotarix® |
Rotavirus vaccine — RV1 |
RotaTeq® |
Rotavirus vaccine — RV5 |
Tdvax®
Tenivac®
|
Tetanus and diphtheria vaccine — Td |
Adacel®
Boostrix® |
Tetanus, diphtheria and acellular pertussis vaccine — Tdap |
Varivax® |
Varicella vaccine — VAR or chickenpox |
Shingrix® |
Zoster vaccine — RZV or shingles |
COVID-19 vaccines |
- Pfizer COVID-19 vaccine (2023-24) — ages 6 months to 4 years old
- Pfizer COVID-19 vaccine (2023-24) — ages 5 to 11 years old
- Comirnaty, Pfizer COVID-19 vaccine (2023-24)
- Spikevax, Moderna COVID-19 vaccine (2023-24)
- Novavax COVID-19 vaccine (2023-24)
|
If a member doesn’t meet the age requirement for a vaccine, Blue Cross and BCN won’t cover the vaccine under the prescription drug plan, and the claim will reject.
Vaccines must be administered by certified, trained and qualified registered pharmacists. |
