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October 2024
Blue Cross, BCN cover additional RSV vaccine
To increase access to vaccines and decrease the risk of vaccine-preventable disease outbreaks, Blue Cross Blue Shield of Michigan and Blue Care Network have added the following to our list of vaccines covered under pharmacy benefits.
Common name |
Vaccine |
Effective date |
Respiratory syncytial virus, or RSV |
mRESVIA® |
Sept. 1, 2024 |
The following lists all the 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 member out-of-pocket cost.
Vaccines with age requirements
Common name |
Vaccine |
Human papillomavirus vaccine, or HPV |
Gardasil 9®
9 to 45 years old |
Vaccines with no age requirements
Common name |
Vaccine |
COVID-19, or 1vCOV-aPS |
Novavax® |
COVID-19, or 1vCOV-mRNA |
- Comirnaty®/Pfizer-BioNTech
- Spikevax®/Moderna
|
Dengue, or DEN4CYD |
Dengvaxia® |
Diphtheria, tetanus, and acellular pertussis, or DTaP |
|
DTaP and inactivated poliovirus, or DTaP-IPV |
|
DTaP, hepatitis B, and inactivated poliovirus, or DTaP-HepB-IPV |
Pediarix® |
DTaP, inactivated poliovirus, and Haemophilus influenza type b, or DTaP-IPV-Hib |
Pentacel® |
DTaP, inactivated poliovirus, Haemophilus influenza type b, hepatitis B, or DTaP-IPV-Hib-HepB |
Vaxelis® |
Haemophilus influenza type b, or Hib PRP-OMP |
PedvaxHIB® |
Haemophilus influenza type b, or Hib PRP-T |
|
Hepatitis A, or HepA |
|
Hepatitis A and B, or HepA-HepB |
Twinrix® |
Hepatitis B, or HepB |
- Engerix-B®
- Heplisav-B®
- PreHevbrio™
- Recombivax HB®
|
Influenza virus |
Influenza vaccine (flu) |
Measles, mumps, rubella, or MMR |
|
Measles, mumps, rubella and varicella, or MMRV |
ProQuad® |
Meningococcal serogroups A, C, W, Y, or MenACWY-CRM |
Menveo® |
Meningococcal serogroups A, C, W, Y, or MenACWY-TT |
MenQuadfi® |
Meningococcal serogroups A, B, C, W, Y vaccine, or MenACWY-TT/MenB-FHbp |
Penbraya™ |
Meningococcal serogroup B, or MenB-4C |
Bexsero® |
Meningococcal serogroup B, or MenB-FHbp |
Trumenba® |
Mpox |
Jynneos® |
Pneumococcal conjugate, or PCV15 |
Vaxneuvance™ |
Pneumococcal conjugate, or PCV20 |
Prevnar 20™ |
Pneumococcal conjugate, or PCV21 |
Capvaxive™ |
Pneumococcal polysaccharide, or PPSV23 |
Pneumovax23® |
Poliovirus, or IPV |
Ipol® |
Respiratory syncytial virus, or RSV |
- Abrysvo™
- Arexvy®
- mRESVIA®
|
Respiratory syncytial virus monoclonal antibody, or RSV-mAB |
Beyfortus™ |
Rotavirus, or RV1 |
Rotarix® |
Rotavirus, or RV5 |
RotaTeq® |
Tetanus and diphtheria, or Td |
|
Tetanus, diphtheria, and acellular pertussis, or Tdap |
|
Varicella, or VAR, chickenpox |
Varivax® |
Zoster, or RZV, shingles |
Shingrix® |
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. |
