Flu Vaccines Now Covered Under Rx Benefit, In Addition to Medical
Thursday, September 6, 2018 at 3:38PM
CWA 4340

Audience:
Labor Relations:  All Regions

Purpose:
To provide notification of a change to coverage for flu vaccines under the AT&T prescription benefit.

Why/Rationale:
To improve convenience when obtaining a flu vaccine at an in-network retail pharmacy.

Details:
Effective August 16, 2018, all employees with prescription drug coverage administered by CVS/caremark are able to obtain, as part of their prescription drug benefit, a flu vaccine at no charge to the employee from any in-network retail pharmacy, including CVS Pharmacy.

Historically, flu vaccines have been excluded under the pharmacy benefit and, instead, covered exclusively under the medical benefit.  However, CVS retail pharmacists are not currently in the Blue Cross Blue Shield of Illinois (BCBSIL) network of medical providers, and thus, cannot provide flu vaccines under the medical benefit to members with medical coverage administered by BCBSIL.

To improve the experience for all plan participants and facilitate participant access and utilization of flu shots, including those with medical benefits administered by BCBSIL, AT&T is removing the exclusion of flu vaccines under the prescription drug benefit.

Effective August 16, 2018, members with medical benefits administered by BCBSIL may present their prescription drug ID card at any in-network retail pharmacy and obtain a flu vaccine under their prescription drug benefit.  Members with medical benefits administered by UHC, may present either their medical ID card or prescription drug ID card and obtain their flu vaccine.  To minimize the chance for confusion, members should take both their medical and prescription drug ID cards with them when they obtain a flu vaccine from an in-network retail pharmacy.

This change does not impact flu vaccines obtained in a network physician’s office or medical clinic.  These will continue to be covered under the medical benefit.  As flu vaccinations are preventive services, no coverage will be provided for flu vaccines obtained out-of-network.

All CVS/caremark network pharmacists have been notified of this change and have been informed to request the prescription drug ID card from AT&T members.

Action Required:
Informational only.

Article originally appeared on CWA Local 4340 | Cleveland, Ohio (http://www.cwa4340.org/).
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