EMPIRE PLAN MEMBERS CAN GET NO CO-PAY FLU SHOTS
Because of the severe influenza epidemic, Governor Cuomo has declared a Public Health Emergency in New York. In response, the Empire Plan has also amended its medical coverage to make it easier for enrollees who have not yet been vaccinated to do so.
The flu vaccinations are now available without a copayment when received at a pharmacy within United Healthcare's national vaccination program network. Participating pharmacies are:
∑ Rite Aid
Vaccinations received at other pharmacies or administered by nonparticipating physicians will be covered under the Basic Medical component of the plan, subject to reasonable and customary charges but not subject to deductible or coinsurance. Enrollees who chose to be vaccinated at a nonparticipating pharmacy or by a nonparticipating physician will need to submit a claim for reimbursement.
Commonly Asked Questions
Q. Why is The Empire Plan coverage for the influenza vaccine temporarily being changed?
A. In response to the rapidly growing number of reported influenza (flu) cases in New York State, Governor Cuomo recently declared a Public Health Emergency. In support of the Governorís Emergency declaration, The Empire Plan is enhancing its coverage options to help enrollees and enrolled dependents receive timely and convenient access to the flu vaccine throughout the duration of the 2013 flu season.
Q. Can my family and I get the flu shot for free? And, can we get it at a pharmacy?
A. Yes, at specified locations. For all Empire Plan enrollees and enrolled dependents, vaccinations received at the following national network pharmacy locations will be provided with no copayment: CVS, Rite Aid, Safeway, Target, and Walgreens. For vaccinations received at all other pharmacies or by a nonparticipating provider, coverage will be provided under the Basic Medical Program subject to reasonable and customary charges but not subject to deductible or coinsurance. Enrollees who choose to be vaccinated at a non-network pharmacy or by a nonparticipating physician will need to submit a claim for reimbursement. Vaccinations received from a participating physician (not through a pharmacy) also will be covered with no copayment.
Q. How long will this updated benefit be in effect?
A. This enhanced benefit is effective February 1, 2013 through May 31, 2013. (The annual flu season usually peaks in February and runs through late spring.)
Q. What if I already got my flu shot?
A. This enhanced coverage does not include reimbursement for flu vaccinations administered prior to February 1, 2013, regardless of location.
Q. Who can I call if I have questions?
A. Contact your physician or pharmacist with general questions about the flu vaccine and to determine if you or your family should get vaccinated. For questions about this enhanced coverage, call The Empire Plan at 1-877-7-NYSHIP (1-877-769-7447) and press 1 for the Medical Program.