Stick it to the Flu® - State Health Plan FAQs

Questions About the Seasonal Flu Shot Program

Where can I get a flu shot?

North Carolina State Health Plan (SHP) members, including retirees, can receive a flu shot at no charge, while vaccine supplies last, at any of the following locations:

  • Physician's office — SHP members may either schedule an appointment for a flu shot or visit a physician's flu shot clinic. If you go to your doctor's office and get the flu vaccine from a nurse, there won't be a charge for the flu vaccine. However, if your physician administers the flu shot or if you receive other services in addition to the flu shot, you'll be responsible for any applicable copayment, coinsurance or deductible amounts.
  • Worksite clinic 1 Some SHP members may get a flu shot where they work and retirees may be able to get a flu shot at the agency from where they retired. Many state agencies have chosen to host employer worksite flu shot clinics this year. Members should contact their Health Benefit Representative to find out if their agency is hosting a worksite flu shot clinic, or check out the listing of all participating agencies on www.shpnc.org.
  • Participating immunizing pharmacists — Available in limited locations, SHP members may go to a participating pharmacist or CVS MinuteClinic to receive a flu shot. In-network pharmacists have contracted with BCBSNC to administer vaccines covered by the State Health Plan, such as the flu shot. Only SHP members ages 14 and older may receive flu vaccinations from pharmacists. To find a participating pharmacist, visit Find a doctor section of our site and under Advanced Search, select for "Pharmacist (Flu & Other Limited Injections)" under Convenience Care. To find a participating CVS MinuteClinic, select "Convenience Care Center" under Advanced Search.
How do I get a flu shot at no charge?

Members ages 18 and older must present their State Health Plan member ID card in order to receive a flu shot. If you don't show your ID card, you'll be required to pay $30 for the flu shot. Dependent children ages 4 to 17 must be accompanied by a parent or guardian. Dependent children under the age of 4 must see their pediatrician or physician to get a flu shot administered in a child's dose.

When can I get a flu shot?

Members should contact their physician, employer, or participating pharmacist to find out when flu shots will be administered and to schedule an appointment.

Why aren't all pharmacists able to provide covered flu shots?

Pharmacists in the BCBSNC network are licensed pharmacists who are certified to provide and administer vaccines, such as the flu shot, in a retail pharmacy. In order for a vaccine received in a pharmacy to be covered, only vaccines administered by pharmacists participating in BCBSNC's networks are eligible for coverage. Pharmacists will only administer flu shots to eligible members1 ages 14 and older. To find participating pharmacists, visit the Find a doctor and under Advanced Search, select "Pharmacist (Flu & Other Limited Injections)" under Convenience Care.

Will my flu shot be covered if I go to an out-of-network provider?

No. All vaccines, including the flu shot, are only covered when given by an in-network provider. Therefore, if you go to an out-of-network provider for your flu shot, the service will not be covered and you will be responsible for all charges.

My child is away in college in North Carolina, and does not have a primary care physician at school. Where can my child get a covered flu shot?

SHP members can receive a flu shot at no charge, while vaccine supplies last, at any of the following locations:

  • Physician's office — SHP members may either schedule an appointment for a flu shot or visit a physician's flu shot clinic. If you go to your doctor's office and get the flu vaccine from a nurse, there won't be a charge for the flu vaccine. However, if your physician administers the flu shot or if you receive other services in addition to the flu shot, you'll be responsible for any applicable copayment, coinsurance or deductible amounts.
  • Participating pharmacists — Available in limited locations, SHP members may go to a participating pharmacist or CVS MinuteClinic to receive a flu shot. In-network pharmacists have contracted with BCBSNC to administer vaccines covered by the State Health Plan, such as the flu shot. Only SHP members ages 14 and older may receive flu vaccinations from pharmacists. To find participating pharmacists, visit Find a doctor and select "Pharmacist (Flu & Other Limited Injections)" under Convenience Care. To find participating CVS MinuteClinics, select "Convenience Care Center" under Advanced Search.

Is there a list of State Health Plan flu shot clinics?

Yes. SHP members should check with their Health Benefit Representative to see if they are hosting a worksite flu shot clinic or visit www.shpnc.org for a complete list of SHP flu shot clinics. SHP members can also get a flu shot at their doctor's office or, in limited locations, in a CVS MinuteClinic or by a participating, immunizing pharmacist. Only SHP members ages 14 and older may receive flu vaccinations from immunizing pharmacists. To find participating CVS MinuteClinics, visit Find a doctor and select "Convenience Care Center" under Convenience Care. To find participating pharmacists visit Find a doctor and select "Pharmacist (Flu & Other Limited Injections)" under Convenience Care.

What about members living outside North Carolina?

If a member goes to an in-network provider in their state, the flu shot will be covered.

My spouse and children are not covered under my plan. Can they get a flu shot too?

Under the North Carolina State Health Plan program, flu shot benefits are limited to members. Nonmembers can receive a flu shot at public health departments. The cost varies and may be covered by private insurance or Medicare.

Who administers the flu shot?

BCBSNC has contracted with Maxim Healthcare Systems to provide flu shots at employer worksite clinics if a flu shot clinic is scheduled. Otherwise, a participating physician, or, in limited locations, an in-network pharmacist or CVS MinuteClinic will administer flu shots depending on the location and set up.

Is FluMist® covered?

Yes, in addition to the seasonal flu shot, FluMist® is available to SHP members at no charge. FluMist® is only appropriate for healthy members ages 2-49 years of age. FluMist® is not available in Maxim worksite clinics, but it is available at most physician's offices and in-network pharmacists. Please note pharmacists can only provide the flu vaccine (shot or nasal spray) to members ages 14 and older.

What about the pediatric flu shot?

The pediatric flu shot for children under the age of 4 will only be available in physician offices. Maxim Healthcare Services will only administer flu shots to children ages 4-17 who are accompanied by a parent or guardian. Pharmacists will only administer flu shots to individuals ages 14 and older.

How do North Carolina state agencies, schools, community colleges and universities sign up for a flu shot clinic?

Health Benefits Representatives or Human Resources department at state agencies, schools, community colleges and universities interested in hosting a worksite flu shot clinic should contact BCBSNC.

How will the State Health Plan communicate the flu shot initiative to North Carolina state agencies, schools, community colleges and universities, retirees and other State Health Plan members?

In August, the State Health Plan sent materials to Health Benefits Representatives and state agencies, schools, community colleges and universities to invite them to host flu shot clinics at their worksites. Beginning in September, members can access information about the flu shot program at www.shpnc.org. Physicians' offices may also promote flu shot clinics in their offices.

What if I have more questions?

You can visit www.shpnc.org for more information or call State Health Plan Customer Service at 1-888-234-2416.

Questions About the Seasonal Flu Vaccine

Who should get the seasonal flu vaccine?

The Centers for Disease Control and Prevention (CDC) recommends that everyone over the age of 6 months should get a flu shot each year.2 The flu, also known as influenza, can affect people of all ages as it spreads through the air from person to person. The virus can be as contagious as the common cold and is easily transmitted from people who are already infected. You can also get the flu from those who've been exposed, but haven't yet developed symptoms. This means that you can be contagious and not even know it.

While everyone should get a flu vaccine each flu season, it's especially important that certain people get vaccinated either because they are at high risk of having serious flu-related complications including: 2

  • Children younger than 5, but especially children younger than 2
  • Pregnant women
  • Adults 65 years of age and older
  • People of any age with certain chronic medical conditions
  • People who live in nursing homes or other long-term care facilities
  • People who live with or care for those at high risk for complications from the flu, including:
    • Health care workers
    • Household contacts of persons at high risk for complications from the flu
    • Household contacts and out-of-home caregivers of children less than 6 months of age
Who shouldn't get the flu vaccine?

Some individuals shouldn't receive the flu shot without consulting their health care provider first, including:

  • Anyone with a severe allergy to chicken eggs
  • People who've had a severe reaction to an influenza vaccination in the past
  • People who have developed Guillain-Barré syndrome within six weeks of getting an flu vaccine
  • Children less than six months of age
  • Anyone with a moderate to severe illness with a fever (you should wait until you've recovered before you get a flu shot)2

Can I get the flu from the vaccine?

Contrary to popular myth, you can't get the flu from the vaccine since it's made from dead and inactive viruses that are noninfectious. The flu strain changes each year, so even if you received a flu shot last year, you'll need to get another one this year to remain protected.

Can I still get the flu after receiving the vaccine?

Yes. Like other vaccines, the flu vaccine isn't 100 percent effective and doesn't take effect until approximately two weeks after it's received. During this time, you'll be just as susceptible to the flu as individuals who haven't received the vaccination. Still, the best option to prevent the flu is to get an annual flu shot

Are there any side effects from the flu shot?

The viruses in the flu shot aren't active, so you can't get the flu from a flu shot. Almost all people who receive the influenza shot have no serious problems from it. The most common side effects are soreness, redness or swelling where the shot was given, a low grade fever and aches. These potential side effects begin soon after the shot is administered and usually last one to two days. Rare side effects include severe allergic reactions. Anyone allergic to chicken eggs should avoid being vaccinated, since the virus used is grown in these eggs. If you have any problems after receiving your flu shot, see your health care provider immediately. 3

What are the chances that providers will run out of flu vaccines this year?

While there are no guarantees of flu vaccine availability, public health officials have determined that supplies of the vaccine are plentiful for 2013 and early 2014.

1 Each clinic has been allocated a supply of vaccine. Shots will be given on a first-come, first-served basis until the supply is depleted. A parent or legal guardian must accompany children ages 4-17 and provide written authorization (Children under 4 should see their physician). The flu shot will be administered by representatives of Maxim Health Systems, a division of Maxim Healthcare Services. 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 administered to high-risk groups before the general public, Maxim will give priority to those who fit the CDC's high-risk criteria.

2 "Key Facts About Influenza (Flu) & Flu Vaccine." Centers for Disease Control and Prevention, Last reviewed, February 13, 2013, http://www.cdc.gov/flu/keyfacts.htm (accessed July 2013)

3 "Key Facts About Seasonal Flu Vaccine." Centers for Disease Control and Prevention, Last reviewed, January 9, 2013 http://www.cdc.gov/flu/protect/keyfacts.htm (accessed July 2013)

®, SM Marks of the Blue Cross and Blue Shield Association. SM1 Mark of Blue Cross and Blue Shield of North Carolina. FluMist® is a registered trademark of MedImmune, LLC.