Blue Medicare HMO Blue Medicare PPO

Flu Shot Program



Frequently Asked Questions


Who is eligible to receive a flu shot without a copayment?

What do I need to show to receive a flu shot without a copayment?

Is there a problem with the flu shot supply this year?

My doctor charged me for a flu shot. Why was I charged a copayment?

Will I get the flu from the flu shot?

Do I need a flu shot every year?

When should I get a flu shot?

Why should I get a flu shot?

How effective is the flu shot?

Who should get a flu shot?

Can I still get the flu after I get the flu shot?

Am I classified as high-risk?

What are the side effects of getting a flu shot?

Who should not get the flu shot?

Where can I get more information about the flu and the flu shot?

If I can't get a flu shot this year, what can I do to protect myself?



Who is eligible to receive a flu shot without a copayment?    top

Members of Blue Medicare HMO and Blue Medicare PPO plans are eligible to receive flu shots without a copayment and the plans will be billed for the service.


What do I need to show to receive a flu shot without a copayment?    top

You need to show your Blue Medicare HMO or Blue Medicare PPO ID card when you visit your doctor’s office to get your flu shot.


Is there a problem with the flu shot supply this year?    top

The flu shot manufacturers, the Federal Drug Administration (FDA) and the CDC are committed to protecting people from the flu. All involved parties are working to meet the projected demand in the United States for the flu vaccine during the upcoming flu season.


My doctor charged me for a flu shot. Why was I charged a copayment?    top

If a member of Blue Medicare HMO or Blue Medicare PPO only goes to the doctor for a flu shot, the copayment is waived. However, if he or she sees the doctor for other services, an office visit copayment may be charged.


Will I get the flu from the flu shot?    top

No. Flu vaccine is created from dead or inactive viruses that are not contagious.


Do I need a flu shot every year?    top

Yes. Influenza viruses change every year. A new vaccine is used annually to fight the most current influenza virus. In addition, the antibody a person develops from the vaccine declines over time.


When should I get a flu shot?    top

Influenza usually occurs from November until April, with activity peaking between late December and early March. The optimal time for flu shots is during October through November; however, it is clinically beneficial to be vaccinated through December and January.


Why should I get a flu shot?    top

Influenza usually leaves its victims unable to function for several days and is responsible for more than 200,000 hospitalizations each year.1 Getting an annual flu shot is your best protection.2)


How effective is the flu shot?    top

Flu vaccine has been determined to be about 75 percent effective in preventing the flu and is your best method of protection.2


Who should get a flu shot?    top

The Centers for Disease Control and Prevention (CDC) recommends that you receive a flu shot if you meet their criteria of high risk or fall under one of the following categories:

  • Anyone who wants to reduce the risk of contracting the flu
  • People over the age of 50
  • People with high blood pressure, irregular heartbeat, history of stroke or heart attack, a chronic disease, diabetes, compromised immune system, anemia, asthma or other breathing problems
  • A health care worker with high-risk patients
  • People who had required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic, kidney or blood cell diseases
  • People traveling to a foreign country
  • People living or working with persons who fit into one of these categories


Can I still get the flu after I get the flu shot?    top

Yes. Like other vaccines, the flu vaccine is not 100 percent effective and does not take effect until one or two weeks after it is received. During this time, you will be just as susceptible to contracting the flu as individuals who have not received a flu shot. Still, the best option to prevent the flu is to get a yearly flu shot.2


Am I classified as high-risk?    top

You are classified as high-risk if you fall under one of the following categories:

  • Anyone 65 years of age or older
  • People who are in contact with persons at increased risk of influenza-related complications
  • Residents or employees of a nursing home or other chronic care facility where some of the residents have chronic medical conditions
  • People who have a chronic medical condition such as: asthma or another lung disease, heart disease, diabetes, kidney disease, or blood disease
  • People who have immune system problems caused either by disease (e.g. HIV or lymphoma) or by medication (e.g. chemotherapy or radiation therapy)
  • Women who will be in the second or third trimester of pregnancy during flu season
  • Children or teenagers, 6 months-18 years of age, who are receiving long-term aspirin therapy
  • Health care workers who care for high-risk patients in the patients' homes


What are the side effects of getting a flu shot?    top

For most people, the vaccination causes no side effects. Less than 1/3 of those who receive a flu shot will experience some soreness at the vaccination site, and only 5 to 10 percent will suffer mild side effects such as low-grade fevers and headaches.


Who should not get the flu shot?    top

Anyone who is allergic to eggs should avoid being vaccinated, since the virus used is grown in hens' eggs.


Where can I get more information about the flu and the flu shot?    top

For more information about this year’s flu season and about the flu shot, visit the CDC website.


If I can't get a flu shot this year, what can I do to protect myself?    top

There are many ways you can protect yourself from contagious illnesses, including the flu:

  • Wash your hands frequently with soap and warm water
  • Avoid touching your eyes, nose and mouth
  • Avoid close contact with people who are sick
  • Cover your nose and mouth when you sneeze or cough
  • If you do get sick, stay home from school or work




Blue Cross and Blue Shield of North Carolina is an HMO, PPO, and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability or geographic location within the service area. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area.

1 "Questions and Answers: Influenza-Associated Hopsitalizations in the United States." Centers for Disease Conteol and Prevention Web site. 7/12/07: http://www.cdc.gov/flu/about/qa/hospital.htm

2 "Fact Sheet:Key Facts about Influenza (Flu) Vaccine." Centers for Diseases Control and Prevention Web site. 7/12/07/ http://www.cdc.gov/flu/protect/keyfacts.htm