Will Your Health Insurance Cover a Flu Shot?

Santa and flu shotNow wouldn’t be a good time to catch the flu. All of us are so busy in December, and no one enjoys being sick. The CDC recommends that most people get a flu shot in order to prevent them from catching the current strain of flu. Will your health insurance cover the cost of a flu shot?

This year, the Centers for Disease Control and Prevention (CDC) recommend that everyone 6 months and older get a flu vaccine. They point out that the flu shot is the most important step in protecting against the flu, which can be a very serious disease.

Will your health insurance cover the cost of a flu shot? It depends. If you bought your current health insurance plan before September 23, 2010, there is a chance it might not cover the cost of a flu shot, or other preventative care.

If you purchased your health insurance plan on or after September 23, 2010, then yes, it will cover the cost of a flu shot, but only if you get it from a network provider. If you get it from a health care provider who is in your network, then you will not be charged a copayment, co-insurance, or for a deductible when you get your flu shot.

Why? It is because an immunization for influenza (or, a “flu shot”) has been defined as a covered preventative service for both adults and children. This took affect on September 23, 2010. Plans bought on or after that day must comply and offer the things that are officially considered to be preventative care without cost to the consumer. Plans bought before that date do not have to, (but may have to when they are renewed).

If you aren’t sure if your insurance plan covers the flu shot, it would be a good idea to contact your insurance company and ask. Or, you might be able to find out by reading the material that came with your plan when you bought it (or renewed it). Both individual plans and employer sponsored (or group) plans may cover a flu shot.

If you, or your child, are covered under a student health plan, or a university health plan, be careful. Students who were covered by the University of Maryland’s health plan who get a flu shot off campus might not receive coverage.

There is potential that other university health plans may have the same issue. Students might want to consider getting their flu shot from the university clinic instead of from the nearest off campus pharmacy if they want the cost covered by their insurance plan.

Image by Quinn Dombrowski on Flickr