[UCRDBR] Medical Plans - Access to Flu Vaccinations.docx

[Departmental Benefits Representatives]

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September 1, 2020

To:          Department Benefits Representatives (DBRs)
From:      UCR HR Benefits Office
Re:          Medical Plans - Access to Flu Vaccinations as of August 31, 2020
The recently issued UC systemwide executive order<https://ucnet.universityofcalifornia.edu/news/2020/08/2020-21-flu-vaccination-executive-order.pdf> requires all members of the UC community to receive an influenza immunization before November 1, 2020. In response to the executive order, we are providing a summary of the various access sites members may use to acquire their vaccination through our medical plans.

Please note that the out-of-pocket costs for flu vaccinations will vary by pharmacy. Members who acquire a flu vaccination from the "Pay Out-of-Pocket and Submit Claim for Reimbursement" column will need to obtain a receipt from the pharmacy and submit a claim for reimbursement from their respective plan.

Health Net is actively reprogramming their pharmacy system to allow for no-cost flu vaccinations without the need to pay out-of-pocket and submit a reimbursement. Once implemented, this will only apply to the UC Blue & Gold plan. The effective date of the new process is not confirmed, but we will update you accordingly.

Members of the Postdoctoral Scholars HMO and PPO plans will continue to pay out-of-pocket and submit their claims to Health Net if they obtain their vaccinations from in-network pharmacies.

Vendor
No-Cost Flu Vaccination
Pay-Out-of-Pocket
Submit Reimbursement Claim
Not Covered
Anthem

  *      In-network provider office

  *      In-network pharmacies
Out-of-network provider office
(out-of-network benefits apply)
(Out-of-network pharmacies)
Health Net

  *      In-network provider office

  *      Participating provider group flu clinics

  *      CVS MinuteClinic
*In-network Pharmacies
(Out-of-network pharmacies)
Kaiser Permanente

  *      KP provider office

  *      KP drive-thru vaccine sites

  *      KP walk-up flu clinics

  *      Target clinics
(Southern CA)
N/A
Non-KP facilities or pharmacies
UnitedHealthcare

  *      KP provider office

  *      KP drive-thru vaccine sites

  *      KP walk-up flu clinics

  *      Target clinics (Southern CA)
Medicare providers who are not willing to bill UnitedHealthcare
N/A

* Health Net is actively reprogramming their pharmacy systems to allow for no-cost flu vaccines without the need to pay out-of-pocket and submit a reimbursement (does not apply to Postdoctoral Scholars HMO and PPO plans). Effective date of this new process is TBD.


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