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Information you need to know for the 2017-2018 flu season

10/04/2017

ConnectiCare members are covered for the flu vaccine. For most members, there is no copayment, coinsurance or deductible if the only reason for a visit is to get 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, ConnectiCare will cover the usual-and-customary amount. If a member pays for the immunization out of pocket, he or she can provide a receipt to ConnectiCare along with a completed Out-of-Plan Reimbursement Form. Medicare members should use this Medicare Out-of-Plan Reimbursement Form.

Members may also call us at 1-800-251-7722 (commercial plans) or 1-800-224-2273 (Medicare plans) to request a reimbursement form. TTY service is also available at 1-800-833-8134 (commercial plans) or 1-800-842-9710 (Medicare Plans).

Please note: The Center for Disease Control and Prevention (CDC) has recommended that Flumist not be used for the 2017-18 flu season due to concerns about its effectiveness against influenza A (H1N1) virus in the U.S. As a result, ConnectiCare will not cover Flumist.

 

MEDICARE CODES FOR
FLU VACCINATIONS

90630

90686

90653

90687

90656

90688

90662

90756*

90673

Q2035

90674

Q2037

90682

Q2039**

90685

 

Administration Code: G0008

COMMERCIAL CODES FOR
FLU VACCINATIONS

90630

90682

90653

90685

90656

90686

90658

90687

90662

90688

90673

90749**

90674

90756*

Administration Codes:
90460, 90461, 90471
90472, 90473, 90474

*Code 90756 is not available for payment until after Jan. 1, 2018, per the Centers for Medicare & Medicaid Services guidance.

**Code 90749 for commercial and Q2039 for Medicare will only be covered through Dec. 31, 2017.