H1N1 (referred to as “swine flu” early on) is a new strain of the influenza virus spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.
H1N1 is expected to be a serious threat this flu season and its vaccine will be in limited supply. All regions of the U.S. have now reported positive cases of the H1N1 flu.
H1N1 Vaccine and Your Benefits Coverage
The federal government will be providing the vaccine to healthcare providers free of charge. However, providers can bill for the administration of the H1N1 vaccine. Your HealthSelect plan will provide coverage for the administration of the H1N1 vaccine, subject to the applicable copay, deductible and coinsurance provisions of your benefits plan.
If you are an in-area participant (residing in Texas and without Medicare coverage), keep your out-of-pocket costs low with network benefits. Use network providers and get referrals to network specialists from your primary care physician (PCP). Visit Provider Finder or call BCBSTX Customer Service at (800) 252-8039 to find network providers. If you do not use a network provider and get a referral from your PCP, you will be subject to a non-network deductible and higher out-of-pocket costs. For more information, refer to the Benefits Book for Employees and Retirees Under Age 65.
If you are an out-of-area participant (Medicare is your primary coverage or you are under 65 residing outside of Texas), you are subject to the out-of-area calendar year deductible and applicable coinsurance. Keep your out-of-pocket costs low by using ParPlan providers; or, if you have Medicare, use providers who accept Medicare assignment. If you do not use a ParPlan provider or a provider who accepts Medicare assignment, you will be subject to higher out-of-pocket costs. For more information, refer to How to Find a Provider When Medicare is Your Primary Coverage or your Benefits Book. You may also call BCBSTX Customer Service at (800) 252-8039 for more information.
CDC Recommendations
Based on its analysis of current situation, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices has recommended prioritizing the following population segments to receive the vaccine:
- Pregnant women;
- People who live with or care for children younger than 6 months of age;
- Healthcare and emergency medical services personnel;
- Persons between the ages of 6 months through 24 years; and
- People ages 25 through 64 years who have chronic health disorders or compromised immune systems.
BCBSTX encourages you to take measures now and throughout the flu season to prevent getting sick. Continue to rely on the CDC for information about H1N1. The CDC has many tips and resources on its website, located at www.pandemicflu.gov.
If you have any medical questions or concerns, we encourage you to talk to your physician.
