Flu Vaccination Coverage and General Information
This year’s combined flu vaccine will cover H1N1, the seasonal influenza B, and a new strain, H3N2.
How are flu vaccines covered under my medical benefits?
All medical plans have seasonal flu vaccine coverage. PacificSource provides coverage for standard flu shots, high-dose flu shots, and flu nasal mist under your medical plan’s immunization benefit.
- County Health Departments: Covered at the participating provider benefit level, applicable deductibles and/or copayments will apply.
- Physician’s Office: Covered subject to participating and nonparticipating provider provisions. Applicable deductibles, coinsurance, and maximum allowances will apply.
Note: As part of healthcare reform, deductibles and coinsurance will be waived for participating providers as policyholders renew on or after September 23, 2010 (grandfathered plans excluded). Please check with your employer to see if this applies to your plan.
Workplace flu shot clinics: Your employer may also host workplace flu shot clinics for their covered members using PacificSource-contracted Employer Flu Vaccination Clinic Participating Providers. Please see your employer for details.
How are flu vaccines covered under my pharmacy benefits?
If your plan has a pharmacy benefit, you can obtain a flu vaccine shot from our participating flu shot pharmacy network. (Mist and high-dose shots are not covered under the pharmacy benefit.) Simply show your PacificSource member ID card at one of our participating flu shot clinics to receive a flu shot at no cost! PacificSource will be billed directly, with no paperwork, deductibles, or copayments required.
Participating pharmacies: To determine if a pharmacy is part of our flu shot pharmacy network, please refer to our Flu Vaccine Network Directories (updated September 12, 2011). They list pharmacies we contract with for flu shot clinics for Idaho, Montana, Oregon, and Washington. The lists are sorted alphabetically by city and pharmacy name. Most, but not all, of the pharmacies in major chain stores and their affiliates have contracted with us to provide flu shot clinics at no cost. These chains include Albertsons, Bi-Mart, Costco, Fred Meyer, Haggen, Hi School, Kmart, Kroger, QFC, Rite Aid, Rosauers, Safeway, Shopko, Smiths, Target, and Top Food chains.
For other states, please refer to our list of CVS Caremark Vaccine Network Pharmacies (14Mb PDF).
Can an employer host a flu vaccine clinic?
If employers have a PacificSource medical plan, they can host an on-site flu vaccine clinic for covered employees, regardless of the company size.
- One vaccine per member per flu season is covered. The high dose vaccine is not available at these clinics.
- Member Cost: $0. The copay, coinsurance, and deductibles will be waived when using a participating vendor.
- Employers can arrange for flu vaccine clinics by contacting one of our participating flu vaccine clinic vendors directly—there’s no need for employers to submit a PacificSource Flu Shot Clinic form. Please see our list of contracted Employer Flu Vaccination Clinic Participating Providers.
Please note, the employer must use a vendor that has a current agreement with us to provide this service; no other vendors will be reimbursed.
Where can I get more information about the flu?
There are other online resources available to you:
Is the flu vaccine a shot or is it available in other forms?
Seasonal flu vaccine is available as a nasal mist and as an injection. However, health officials recommend that pregnant women, children younger than two, and people with asthma and other chronic respiratory diseases receive the injectable vaccine.
How long is someone contagious before symptoms start?
An individual is contagious one to two days before symptoms start.
How long can an infected person spread the flu virus to others?
People infected with seasonal flu may be able to infect others from one day before getting sick to five to seven days after. This infectious period can be longer with some people, especially children and people with weakened immune systems.
How long does it take for the vaccine to work?
After vaccination, most people are immune within 8 to 10 days.