Does Anthem Cover Flu Shots?
- Anthem Medicare Advantage (Part C) plans cover flu shots because they're also covered by Original Medicare (Parts A and B). You may be able to find Anthem Medicare plans that include prescription drug coverage, vaccinations, dental, hearing, vision, transportation and more.
Many people will stop to ask themselves if their flu shot will be covered by their insurance before making an appointment. So does Anthem cover flu shots?
Anthem Blue Cross Blue Shield is part of the Anthem family of brands and is a blue health plan brand. Medicare Advantage (Medicare Part C) plans from Anthem Blue Cross Blue Shield, or simply “Anthem” for short, do indeed cover flu shots.
In fact, all health insurers are bound by a rule in the Affordable Care Act (ACA, also called Obamacare) that requires health insurance plans to cover all federally recommended vaccines in full, when certain criteria are met. That means no copayment, coinsurance or deductible is charged to the patient. And among those federally recommended vaccines is the flu shot.
Anthem Medicare Advantage plans also cover an annual flu shot because it’s also covered by Medicare Part B. All Medicare Advantage plans – including those offered by Anthem and its affiliate companies – are required to cover everything that Original Medicare (Part A and Part B) covers.
Some Anthem Medicare Advantage plans may also offer additional benefits such as prescription drug coverage, hearing, dental, vision, transportation, meal delivery, gym memberships and more, all of which aren’t typically covered by Original Medicare.
You can use the online Anthem flu shot finder tool to locate a facility near you offering flu shots covered by Anthem.
When Do Anthem Medicare Advantage Plans Pay for Flu Shots?
Medicare Part B covers one flu shot annually. And if the provider administering the shot accepts Medicare assignment, there is no charge to the beneficiary. Medicare Advantage plans are required by law to provide the same coverage as Medicare Part A and Part B.
If you have an Anthem Medicare Advantage plan, your flu shot will be covered, and you should have an opportunity to pay nothing out of pocket if you meet certain restrictions put forth by your plan. You may need to visit an in-network provider to receive full coverage of your flu shot, and you may have to pay higher out-of-pocket costs if you get your flu shot from an out-of-network provider or pharmacy.
It’s important to note though that each individual insurer retains a little bit of wiggle room within those federal guidelines.
- For instance, an insurer may require that the flu shot be administered by an in-network provider. If the shot is received at an out-of-network location, the insurer may be allowed to charge a copayment or apply a deductible.
- An insurer might only grant full coverage for a flu shot when received during an annual physical or wellness exam. If the shot is given outside of that appointment, you might incur charges.
- Likewise, insurers may also be allowed to charge a copayment for an office visit or apply the costs to your deductible if any other services were rendered during the same appointment.
As with most things concerning your health insurance coverage, it’s best to consult directly with your plan carrier. In the case of Anthem, call the phone number on your plan ID card and follow the automated prompts to speak with a representative who can answer your questions about flu shot coverage.
You may also log into your online Anthem account to review the terms of your coverage.
More Information About the Flu Shot
The CDC recommends that everyone age 6 months and older should receive a flu shot every year, with only rare exceptions. The flu shot is especially critical for those at a higher risk of severe complications from the flu, such as individuals who are 65 and over, have certain chronic conditions, are pregnant, are part of specific races or ethnic groups and more.
You can learn more about the 2021-2022 flu season and the flu shot itself in our complete guide to the flu vaccine.
You can compare Anthem Medicare Advantage plans online to find out how the plans available where you live cover the flu shot, and you can compare other plan benefits that may include things like prescription drug coverage, dental, hearing, vision and more. You can also call to speak with a licensed insurance agent to learn more.