2020 – 2021 Influenza Season Information

For most members, there is no copayment, coinsurance or deductible if the only service that is provided during the visit is the administration of a flu shot. If there is an additional, separate reason billed for a visit, applicable copayment, coinsurance and deductible will apply.

If a member receives a flu vaccination from a non-participating provider, we cover the usual-and-customary amount. If a member pays out of pocket, he or she can provide a receipt to us along with a completed Out-of-Plan Reimbursement Form.

Medicare members should use this Medicare Out-of-Plan Reimbursement Form.

Medicaid Managed Care (MMC) members will continue to access immunization services through their health plans. For Medicaid Managed Care Organization (MCO) billing guidance please contact the plan. Individual plan information can be found at: https://mmcdruginformation.nysdoh.suny.edu/