"The Big Picture" Newsletter

October 2009 Issue

H1N1 (Swine) Flu Vaccine Coverage

The secretary of Health and Human Services has renewed the declaration that a nationwide public health emergency exists in relation to the H1N1 virus. The Centers for Disease Control (CDC) has designated vaccination as the most powerful public health tool for control of influenza.

In keeping with our mission to improve the health, well-being and sense of security of our customers, CIGNA will communicate to our fully insured clients that we will cover H1N1 flu shot administration in any setting at 100 percent of the Medicare allowable rate.1 Deductibles will not apply – covered individuals will not be asked for a copay or coinsurance. Self-insured clients have the option to opt-out of this process. This will be CIGNA’s standard approach until the potential for an emergency situation subsides.

This communication relates to the swine flu vaccine called H1N1 only. Coverage for other vaccines will be in accordance with the individual’s plan.

Because the federal government will be paying for the vaccine itself, CIGNA and other private health plans will only be asked to reimburse for the administration of the vaccine. We expect that both the traditional (i.e., physician offices) and non-traditional (e.g., health fair and retail pharmacy) sites will be used as distribution centers for the administration of the H1N1 vaccines.

By providing first dollar coverage, CIGNA is supporting the CDC recommendations and stressing the importance of making every effort to provide vaccination to appropriate individuals across the country. Self-insured clients who do not wish to have 100 percent coverage must notify their CIGNA representative by October 9, 2009.

For additional information, please contact your CIGNA representative.

1 The estimated cost of administering the H1N1 flu vaccine is approximately $21 depending on the geographic location.

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