The flu season runs from October through April each year, and the Centers for Disease Control and Prevention (CDC) notes that September and October are good times for patients to vaccinate against the flu.
Providers play a vital role in informing patients about protecting themselves against the flu and making healthy decisions about scheduled vaccinations. You are trusted to address widespread disinformation, dispel misconceptions, and engage patients in their health, including vaccination safety and efficacy.
The CDC continues to recommend that patients ages six months and older receive a flu vaccine every year, with rare exceptions. This recommendation includes pregnant patients; our Prenatal Immunization Status (PRS-E) HEDIS tip sheet offers useful insight into the PRS-E measure, which assesses the percentage of deliveries in which patients receive vaccinations for influenza, tetanus, as well as diphtheria toxoids and acellular pertussis (Tdap). Flu vaccination provides important protection from influenza and its complications, with the CDC reporting that in the 2019-2020 flu season alone, the flu vaccine prevented an estimated 7.5 million illnesses, 3.7 million medical visits, 105,000 hospitalizations and 6,300 influenza-related deaths in the United States.
Harvard Pilgrim covers flu vaccines at retail pharmacies for a $0 cost share for commercial members ages 3 years and older.
For most Tufts Health Plan products, flu shots are covered at no cost. If members pay out-of-pocket for their flu vaccine, they can submit for reimbursement from Tufts Health Plan. If members are unsure about their plan’s benefit or where they can get a flu shot, please advise them to call Member Services at the number on their Tufts Health Plan member ID card.
For members of Harvard Pilgrim’s StrideSM (HMO)/(HMO-POS) Medicare Advantage plans and Tufts Health Plan Senior Products, flu vaccines are covered at $0 cost share (billed under Part B) at retail pharmacies or in doctors’ offices.
The CDC has a robust Influenza website that provides valuable information about vaccination, infection control, prevention, treatment, and diagnosis of seasonal influenza — including Information for Health Professionals and Influenza ACIP Vaccine Recommendations pages.
Annmarie Dadoly,
Senior Manager, Provider Communications
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Editor
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