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March 2024
Blue Cross and BCN covers additional vaccines
To increase access to vaccines and decrease the risk of vaccine-preventable disease outbreaks, Blue Cross Blue Shield of Michigan and Blue Care Network added the following vaccine to our list of vaccines covered under the pharmacy benefit.
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Vaccine |
Common name and abbreviation |
Effective date |
Penbraya™
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Meningococcal serogroups A, B, C, W, Y vaccine (MenACWY-TT/ MenB-FHbp)
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Jan. 1, 2024
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The following charts list vaccines that are 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 out-of-pocket costs.
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
Vaccine |
Common name and abbreviation |
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Dengue vaccine (DEN4CYD) |
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Diphtheria, tetanus, and acellular pertussis vaccine (DTaP) |
- Diphtheria and tetanus toxoids
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Diphtheria, tetanus vaccine (DT) |
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DTap and inactivated poliovirus vaccine (DTaP-IPV) |
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DTaP, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV) |
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DTaP, inactivated poliovirus, Haemophilus influenzae type b, and hepatitis B vaccine (DTaP-IPV-Hib-HepB) |
- ActHIB®
- Hiberix®
- PedvaxHIB®
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Haemophilus influenzae type b vaccine (Hib)
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Hepatitis A (HepA) |
- Engerix-B®
- Heplisav-B®
- PreHevbrio™
- Recombivax HB®
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Hepatitis B (HepB) |
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Hepatitis A & B (HepA-HEPB) |
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Measles, mumps, rubella vaccine (MMR) |
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Measles, mumps, rubella and varicella vaccine (MMRV) |
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Meningococcal serogroups A, C, W, Y vaccine (MenACWY-CRM) |
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Meningococcal serogroups A, C, W, Y vaccine (MenACWY-D) |
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Meningococcal serogroups A, C, W, Y vaccine (MenACWY-TT) |
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Meningococcal serogroups A, B, C, W, Y vaccine (MenACWY-TT/ MenB-FHbp) |
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Meningococcal serogroup B vaccine (MenB-4C) |
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Meningococcal serogroup B vaccine (MenB-FHbp) |
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Pneumococcal 15-valent conjugate vaccine (PCV15) |
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Pneumococcal 20-valent conjugate vaccine (PCV20) |
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Pneumococcal 23-valent polysaccharide vaccine (PPSV23) |
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Poliovirus (IPV) |
- Arexvy™
- Abrysvo™
- Beyfortus™
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Respiratory syncytial virus (RSV) |
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Rotavirus vaccine (RV1) |
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Rotavirus vaccine (RV5) |
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Tetanus and diphtheria vaccine (Td) |
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Tetanus, diphtheria and acellular pertussis vaccine (Tdap). |
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Varicella vaccine (VAR) (chickenpox) |
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Zoster vaccine (RZV) (Shingles) |
Covid Vaccines |
- Pfizer COVID-19 Vaccine (2023-2024), 6 months to 4 years old
- Pfizer COVID-19Vaccine (2023-2024), 5 to 11 years old
- Comirnaty, Pfizer COVID-19 Vaccine (2023-2024)
- Novavax, COVID-19 Vaccine (2023-2024)
- Spikevax, Moderna COVID-19 Vaccine (2023 -2024)
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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. |
