February 1, 2017
Medicare coverage for vaccines can be complicated. We encourage our Premera Blue Cross Medicare Advantage Plan members to work with their provider and our customer service team to understand the coverage for vaccines up front. This helps patients avoid unexpected bills for vaccines given in the provider office.
Some vaccines are covered at no cost to the member when given in an in-network provider's office, such as flu and pneumonia vaccines. Other vaccines, such as Hepatitis B, may be covered at no cost to the member depending on the patient's medical history. Some vaccines, such as Zostavax® (shingles vaccine), are only covered with a member cost share under the member's Part D prescription drug coverage (subject to benefit, deductible, and coverage gap).
Premera Blue Cross Medicare Advantage members generally pay less for Part D vaccines when they are administered at an in-network preferred pharmacy. If your patient needs help finding a pharmacy offering vaccine services, direct them to Premera Blue Cross Medicare Advantage Customer Service at 888-850-8526, Monday through Friday, 8 a.m. to 8 p.m., Pacific time.