Flu Program – Frequently Asked Questions
Questions About the Flu Shot Program
- Can I get a flu shot at no cost?
A: In most cases, you can get a flu shot at no charge if you have one of these plans: 1
- Blue Cross NC plans with preventive care benefits
- Blue Medicare HMOSM, PPOSM or SupplementSM
- North Carolina State Health Plan
- North Carolina Federal Employee Program
- Where can I get a flu shot that's covered?
A: You can get a flu shot during flu season at: 2
- Worksite clinics2 — Some members may be able to get a flu shot where they work. Many employers have free on-site flu shot clinics. Employers may also let family members come to the flu clinic. Participants must be over 18. You can ask your Human Resources manager for more information.
- Doctor's offices — You can make an appointment for a flu shot or go to a doctor's scheduled flu clinic. If you get other medical care in the same visit, you will have to pay a fee (e.g., copay, coinsurance, or deductible fees). Don't have a doctor? Visit Find a doctor.
- Pharmacies (if applicable)
Flu shots can now also be covered under the member's Prime pharmacy benefits on most Blue Cross NC plans. Members just need to show their ID card at the pharmacy. These vaccines will be covered at 100% under their Prime pharmacy benefits.
The following plans are excluded from coverage of the flu shot under the member's pharmacy benefits:
• The State Health Plan
• FEP plans
• Medicare Part D plans
• ASO members with a Net Results Rx formulary
Members on these plans must continue to use one of the other flu shot options, and their medical benefits will apply.
- In-network immunizing pharmacists and MinuteClinics) — Members age 18 and older may go to an in-network, immunizing pharmacist or MinuteClinic to get a flu shot. Some members may have to pay a fee (e.g, copay, coinsurance, or deductible fees).
Visit Find a doctor to find a location. Verify your ZIP code and type "Pharmacist" into the search box. Select "Pharmacist (Flu & Other Limited Injections)". To find a Minute Clinic or other convenience care center, type "Convenience Care Center" into the Search box.
- In-network health department: You may visit an in-network health department to get a flu shot. Some members may pay a fee, based on their plan. If you get other medical care in the same visit, you will have to pay a fee (e.g., copay, coinsurance, or deductible fees).
- Why can't all pharmacists give flu shots?
A: Only an immunizing pharmacist or pharmacy in the Blue Cross NC network can give flu shots. Visit Find a doctor and use your ZIP code to search for a location. Type "Pharmacist" into the search box and under Specialties, select "Pharmacist (Flu & Other Limited Injections)".
- When can I get a flu shot?
A: You can ask your doctor, employer, or in-network immunizing pharmacist or pharmacy to find out when flu shots will be given and to make an appointment.
- How do I know if I'm able to get a flu shot at no charge?
A: If you don't know if your Blue Cross NC plan covers flu shots as part of your preventive care benefits or if you will have a deductible to pay, check your Blue Cross NC benefit booklet. You can also ask your Human Resources manager or call Blue Cross NC at the toll-free number listed on your insurance card.1
- Can I get my flu shot from a doctor who's not in the Blue Cross NC network?
Yes, but you will be charged for the flu shot. To find an in-network doctor, visit Find a doctor.
- What if I live outside North Carolina?
- You may be able to get flu shots at worksite clinics outside the state.
- Some members may pay a fee depending on their plan.
- Eligible members who go to an in-network vaccinating pharmacy can get a flu shot under their Prime pharmacy benefit
- Is there a cost?
You may have to pay a fee for a flu shot when:
- Your plan charges a copay for an office visit. (you may not have a copay if the office visit is ONLY for a flu shot)
- Your plan doesn't cover preventive care.
- Your plan has a deductible that hasn't been met.
- I'm not a BCBSNC member. I don't have preventive care benefits. Can I still get a flu shot at no charge?
Flu shots may also be given at a public health department. Cost varies and may be covered by private insurance or Medicare.
- Is FluMist® covered?
Yes, the Centers for Disease Control and Prevention (CDC) says that FluMist can be used for the 2020-2021 flu season. It is only appropriate for healthy people between the ages of 2 and 49 who are not pregnant.
- Can children get the flu shot?
Children under the age of 4 can only get a flu shot in a doctor's office. People age 18 or older can get a flu shot at work, if their employer has a flu shot clinic. Immunizing pharmacists will only give the flu shot to people ages 18 and older.
- What if I have more questions about the seasonal flu vaccine?
Our nurses can answer your questions about the flu or other health questions at any time at 1-877-477-2424.
- What if I'm not feeling well and I'm unsure where to go for care?
Our nurses can help you decide the best place to go. Call anytime at 1-877-477-2424. If you're not sure you have the flu, the chart at bcbsnc.com/careoptions may help you decide.
Questions About the Flu Shot
- Who should get a flu shot?
The Centers for Disease Control and Prevention (CDC) says that everyone over the age of 6 months should get a flu shot every year. 3 The flu, also known as influenza, spreads quickly through the air from person to person. You can also get the flu from people who have come in contact with it but haven't shown any symptoms. This means that you can have the flu and spread it and not even know it.
While you should get a flu shot every year, it's even more important that certain people get the shot because they may get sicker from the flu than most people. Those people are:3
- Children younger than five, but especially children younger than two
- Pregnant women and women up to two weeks after the end of pregnancy
- People staying in nursing homes and long-term care facilities
- American Indians and Alaska Natives
- Adults 65 years of age and older
- People of any age with certain medical conditions (ask your doctor)
- People who are obese with a body mass index of 40 or greater
- Who shouldn't get the flu shot? 3
Some people shouldn't get the flu shot without talking their doctor first. These people are:
- Anyone with a severe allergy to chicken eggs
- People who've had a severe reaction to the flu shot in the past
- People who have developed Guillain-Barré syndrome within six weeks of getting a flu shot
- Children less than six months of age
- Can I get the flu from the flu shot?
No, you can't get the flu from the flu shot since it's made from viruses that are not alive and can't infect you. The flu strain changes each year, so even if you got a flu shot last year, you'll need to get another one this year.
- How well does the flu shot work?
How well the flu shot works depends on three things:
- The person's age
- The person's health
- Whether or not it is a "match" to the flu virus currently in the community.
- Are there any side effects from the flu shot?
Almost all people who get the flu shot have no serious problems from it. The most common side effects are soreness, redness or swelling where the shot was given. Some people get a low grade fever and aches. If they happen, side effects begin soon after the shot is given and can last one to two days.
Severe allergic reactions to the flu shot are rare. Anyone who is allergic to chicken eggs should not get the flu shot since the virus used in the shot is grown in these eggs. If you have any problems after getting your flu shot, see your doctor right away.3
- Does the flu shot contain thimerosal?
Thimerosal is a preservative that prevents the growth of germs and bacteria. Based on research, the FDA, CDC and NIH say thimerosal is safe. Most flu shots use multi-dose vials that contain thimerosal. Single dose vials do not contain thimerosal. For more information please go to: http://www.cdc.gov/flu/protect/vaccine/thimerosal.htm.
1 Seasonal flu shots are available for eligible members and covered at 100 percent for those members with a non-grandfathered plan.
2 Each seasonal flu clinic has been given a set amount of shots. Shots will be given on a first-come, first-served basis until the supply is gone. All participants must be 18+. The flu shots will be given by agents of LabCorp. Members should refer to their Benefit Booklet for more information about their preventive care benefits. In the event that the Centers for Disease Control and Prevention (CDC) recommends that flu shots be given to "priority groups" before the general public, LabCorp will give priority to those who fit the CDC's high-risk standards.
3 "Key Facts About Seasonal Flu Vaccine." Centers for Disease Control and Prevention, http://www.cdc.gov/flu/prevent/keyfacts.htm (accessed August 2020)
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