We know there’s a lot of talk about flu shots, COVID shots and other vaccines right now. Nothing is changing for your Health Fund coverage. We’re closely monitoring the decisions coming out of Washington, DC, as well as with some states making their own policy decisions, and will keep you posted if anything impacts your benefits and coverage from the Fund. Our coverage of flu shots and COVID vaccines is staying the same.
You have two ways to get your flu shot that will be covered under the Health Plan — at your doctor’s office or at a pharmacy.
Flu Shots and Vaccines Covered by Optum Rx
Your prescription drug benefits for both Tiers cover flu shots and other vaccinations 100%, subject to the mandates of the Affordable Care Act (ACA), when you go to a retail pharmacy. You’ll need to show the pharmacist your Optum Rx ID card. We recommend contacting your local pharmacy before you go to make sure the vaccination(s) that you want are available and to check if you need to make an appointment. Just about all major retail pharmacy chains are in the Optum Rx network. You can visit Optum’s website or call them at (800) 797-9791; TTY 711 for more information.
Flu Shots and Vaccines Covered by Cigna/Kaiser HMO Plans
Flu shots and other vaccinations are also covered under the Cigna and Kaiser HMO medical plans at no cost — but only when obtained from in-network providers through their respective medical plan networks. For Cigna, this also includes retail pharmacies that are in-network. Coverage for vaccines obtained from an out-of-network medical provider not contracted with Cigna will be based on the rules for your Tier of coverage
Some of the major participating in-network retail pharmacies with Cigna include Walgreens, Rite Aid, Duane Reade, Costco, etc. For a complete list, review this flier from Cigna that lists other participating pharmacies that are in-network with Cigna. For a complete list of in-network providers, including locating retail pharmacies, please visit www.mycigna.com.
You shouldn’t need to make an appointment to get a vaccine, but you should call your pharmacy to make sure your vaccine is available at that location — and to see if they suggest making an appointment.
Please remember to use your Cigna Medical Card when getting your vaccines at the retail pharmacy. The pharmacy will need the medical ID and group number listed on your ID card. Your pharmacist may also need to use one of the following BIN and PCN codes in order to make certain that the claim submitted to Cigna gets approved:
Change Healthcare/Emdeon
- BIN: 004766
- PCN: COM62308
Omnisys
- BIN: 004303
- PCN: CIGPPOIMM
NOTE FOR CIGNA COVERAGE ONLY: CVS retail pharmacies that do not have CVS Minute Clinics and Health Hubs are considered out-of-network providers with Cigna. Only vaccines obtained at CVS locations with Minute Clinics and Health Hubs would be processed as an in-network benefit.
Questions?
If you have any questions, please contact the Benefit Services Department and a representative will assist you during the hours of 9:30 AM to 5:30 PM EST.