Expanded access to vaccinations streamlines member experience

In Dec. 2018, UnitedHealthcare expanded coverage for the influenza vaccine under the pharmacy benefit for fully insured members. UnitedHealthcare is expanding coverage further for the influenza vaccine and adding other preventive vaccines to the pharmacy benefit for both fully insured members (effective Aug. 1, 2019), as well as ASO members (effective Sept. 1, 2019) that opt in. This is an extension of coverage of vaccines, and coverage will remain under the medical benefit.

Expanding the availability of preventive vaccines under the pharmacy benefit increases member access to the vaccines from 30,000 dispensing retail pharmacies to 50,000 pharmacies. This means fewer members will be turned away at their preferred pharmacy when seeking a vaccine.

Preventive vaccines will still be $0 copay for members and will bypass deductibles. 

All Savers® Only: All Savers members will see a positive change. Currently, when they receive a flu shot at the retail pharmacy, they must pay out-of-pocket and submit a paper claim for reimbursement. Under the new benefit, the pharmacy will be able to submit the claim electronically so the paper claim requirement will not apply.

For a list of vaccines covered under the pharmacy benefit, as well as a list of pharmacies included in the network, click here. For any other questions about this new pharmacy benefit, contact your UnitedHealthcare representative.

Certain preventive care services, including immunizations, are provided as specified by the Patient Protection and Affordable Care Act (PPACA), with no cost-sharing to you. Some plans may require copayments, deductibles and/or coinsurance for these benefits. Always review your plan documents to determine your specific coverage.

Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates.  Administrative services provided by United HealthCare Services, Inc. or their affiliates.

Administrative services provided by United HealthCare Services, Inc. or their affiliates. Stop-loss insurance is underwritten by All Savers Insurance Company (except MA, MN, and NJ), UnitedHealthcare Insurance Company in MA and MN, and UnitedHealthcare Life Insurance Company in NJ. 3100 AMS Blvd., Green Bay, WI 54313 (800) 291-2634.