It’s time for your annual flu and pneumonia vaccinations, and it’s important to understand how that vaccination will be paid for through your medical insurance. You may receive your vaccine at your doctor’s office or a local pharmacy. If you do receive your vaccine at a covered pharmacy, understand that the payment for the vaccination is administered through your medical insurance, not your prescription coverage.

Highmark BlueCross BlueShield members are covered for flu and pneumococcal vaccines received from a pharmacist at a participating pharmacy. Contracting pharmacies submit claims to Highmark BCBS and receive payment at the network benefit level for preventive services.

Members who receive a vaccine from a non-contracting pharmacy may submit a claim to Highmark and be reimbursed at the out-of-network benefit level for preventive services. 

Contracting pharmacies include national chains such as Giant Eagle and Kmart, as well as local pharmacies. Please ask your pharmacy if they are participating with your network on this program.

It’s easy to take advantage of this program at contracting pharmacies: