July 2018
Reminder: High-dose Influenza Vaccines Recommended Only for People Age 65 and Older
Before the 2018-2019 flu season begins, Blue Cross and Blue Shield of Illinois (BCBSIL) would like to remind you that the flu vaccines called high-dose influenza are only approved by the U.S. Food and Drug Administration (FDA) for those people age 65 and older. These include Fluzone High-Dose and Fluad, which were available for the 2017-2018 flu season. New vaccines could become available for the 2018-2019 flu season.
It has come to our attention through claims data that some members under age 65 are being billed for the more expensive high-dose influenza vaccines. Please be aware of correct vaccine administration as well as accurate coding when filing your claims. Refer to the Table of Approved Vaccines on the Centers for Disease Control and Prevention (CDC) website for the most recent updates.
Getting the flu vaccine is the best way to prevent the spread of the flu.1 Therefore, we encourage our members and communities to invest in their health and get vaccinated. We also want to help ensure members are receiving the appropriate vaccine for their age according to the CDC website and the Advisory Committee on Immunization Practices (ACIP).
Details on our complete, approved immunization schedule, Preventive Services Policy CPCP006, can be found on the BCBSIL Provider website.
1 CDC, Preventive Steps, Feb. 9, 2018, https://www.cdc.gov/flu/consumer/prevention.htm
The above information is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment.
References to third party sources or organizations are not a representation, warranty or endorsement of such organizations. Any questions regarding those organizations should be addressed to them directly.
The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.