Local News

BCBSNC To Cover Cost Of FluMist Intranasal Flu Vaccine For Members

Posted December 11, 2003

— In the wake of shortages of injectable influenza vaccines,

Blue Cross and Blue Shield of North Carolina,

the state's largest health insurer, will increase reimbursement to physicians to cover the cost for the FluMist intranasal vaccine for its members.

The coverage expansion begins Thursday and will last throughout flu season.

The

U.S. Food and Drug Administration

approved FluMist for use this season for healthy adults age 18 to 49 and healthy children and adolescents age 5 to 17.

Typical charges for FluMist are between $60 and $70, several times the cost of regular flu vaccines. BCBSNC members may obtain the intranasal or injectable flu vaccine at their doctor's office or a clinic without making any out-of-pocket payment for either vaccine. Any standard office copay included in a member's policy will still apply.

"This flu season is a severe one, and as more people receive their flu shots, it is depleting the stock of vaccine," said Bob Greczyn, BCBSNC president and chief executive officer. "That's why we are paying all costs for FluMist for our members who may safely and effectively take it.

"We are encouraged that so many North Carolinians are protecting themselves with flu vaccines this year. But we also recognize the challenge created by the dwindling supplies of the vaccine."

The federal

Centers for Disease Control and Prevention

on Thursday said North Carolina is one of 24 states with widespread flu activity.

BCBSNC has provided coverage for FluMist as an in-network benefit for members of some of its health plans. But many members have paid out-of-pocket for any costs beyond the amount doctors are reimbursed.

Making FluMist available to BCBSNC members who may safely take it potentially will leave more of the regular vaccine available to North Carolinians who are not able to take FluMist, said Dr. Robert T.Harris, BCBSNC senior vice president and chief medical officer.

"We believe the appropriate use of FluMist, which the FDA has deemed safe and effective for many healthy people, will help alleviate shortages of the traditional flu vaccine, which can then be given to higher-risk persons," Harris said. "The severity of this flu season is proving challenging to doctors and public health officials in North Carolina, and it is beneficial to have flu vaccines available to help protect people."

Among those who should not have the FluMist vaccine, according to the FDA, are: children under age 5; adults over age 49; people with asthma or chronic disorders of the lungs, heart, kidneys or liver; people with diabetes, AIDS or cancer; pregnant women in their second or third trimester; and people who have symptoms of a cold or the flu at the time they are seeking immunization. Members should consult their physician regarding which vaccine, if any, is appropriate for them.

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