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OGBís PPO, HMO, Medical Home HMO and CDHP-HSA health plans cover flu vaccinations

Flu shots can be administered at doctorís offices, health fairs, hospitals, medical clinics and pharmacies
Immunization shots for influenza are a covered benefit under OGBís PPO, HMO, Medical Home HMO and CDHP-HSA health plans whether the shot is administered at a doctorís office, health fair, hospital, medical clinic or pharmacy.

Claims for flu shots are processed by each OGB health plan subject to any applicable co-payment and deductible. If your plan has an annual deductible and you have not yet met that deductible, the claim is applied to the deductible and the plan pays any amount that exceeds the deductible. If your plan has no deductible but requires a co-payment, the plan will reimburse you for the amount that exceeds your co-payment.

If you receive your flu shot from a doctorís office or medical clinic that is a participant in your health planís network, the medical facility will file a claim for you.

If you receive your flu shot at a pharmacy and your pharmacy agrees to file a claim directly with your health plan provider, no action is needed on your part.
However, if the doctor or pharmacy does not file a claim for you, you must file a claim to receive benefits. Here are the steps you need to take...
  1. Get your flu shot and pay for it. If you have an OGB general-purpose flexible spending arrangement (GPFSA) card, do not use it to pay for the vaccine. Be sure the receipt includes the date administered, the cost, the vaccine name, the name of the person who received the shot and the medical provider or pharmacist who administered it.

  2. Follow these instructions to file a claim...
    • Click on the link below to your health planís claim form.
    • Complete the form online and print it, or print the blank form and fill it in using blue or black ink.
    • Sign and date the form. Mail the form and the original receipt (not a cash register receipt or a copy) to the address listed below (and on the form).
Health Plan Covered Benefit Link to Claim Form Claim Form Mailing Address
PPO
(Administered by Blue Cross & Blue Shield of Louisiana)
Covered at 90%;
subject to deductible
Flu shots rendered at a pharmacy:
Flu Vaccination Claim Form

Flu shots rendered at health fairs, job sites, etc.:
BCBSLA 1500 Claim Form
Blue Cross & Blue Shield of Louisiana
P.O. Box 98029
Baton Rouge, LA 70898-9029
HMO
(Administered by Blue Cross & Blue Shield of Louisiana)
Covered at 100%
of allowable amount;
no deductible
Flu shots rendered at a pharmacy:
Flu Vaccination Claim Form

Flu shots rendered at health fairs, job sites, etc.:
BCBSLA 1500 Claim Form
Blue Cross & Blue Shield of Louisiana
P.O. Box 98029
Baton Rouge, LA 70898-9029
Medical Home HMO
(Fully insured by Vantage Health Plan)
Covered at 100%
of allowable amount;
no deductible
Flu Vaccination Claim Form
(Medical Home HMO plan only)
Vantage Health Plan
130 DeSiard St., Suite 300
Monroe, LA 71201
CDHP-HSA
(Administered by Blue Cross & Blue Shield of Louisiana)
Covered at 80%;
subject to deductible
Flu shots rendered at a pharmacy:
Flu Vaccination Claim Form

Flu shots rendered at health fairs, job sites, etc.:
BCBSLA 1500 Claim Form
Blue Cross & Blue Shield of Louisiana
P.O. Box 98029
Baton Rouge, LA 70898-9029

If you have a general-purpose flexible spending arrangement (GPFSA), you can file for reimbursement of any remaining out-of-pocket costs from DataPath Administrative Services (the GPFSA administrator) after your claim has been processed by your health plan and you have received an explanation of benefits (EOB). Hereís what to do...
  • Complete a GPFSA medical expense claim reimbursement form.
  • Fax the completed form and a copy of your EOB to 1-888-472-6777 (toll-free) or mail your claim to DataPath Administrative Services, 1601 Westpark Dr., Suite 9, Little Rock, AR 72204.
Centers for Disease
Control and Provention

Your Online Source for Credible Health Information
Click here
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