With the impending delivery of the new vaccine for the novel A H1N1 flu virus, Blue Cross and Blue Shield of Illinois (BCBSIL) wants to make our network physicians aware of our policy concerning coverage of charges for administering the vaccine for BCBSIL members.

Some members' health plan medical benefits may not cover vaccination charges. In order to ensure our members get the best treatment available, BCBSIL has implemented a policy to cover administration of the vaccine for members of our fully insured health plans without regard to whether their current plan covers vaccinations. We will cover this fee without applying it to their deductible or coinsurance. We will also work proactively with all the employers we work with who have self-funded employer health benefit plans to recommend they adjust their benefit coverage to also cover administration of the vaccine.

In order to benefit from this special coverage, a member must receive the vaccination from a BCBSIL network provider. When using a provider that is not in the BCBSIL network, normal benefit coverage will apply.

This coverage will be available for the five priority populations the Centers for Disease Control and Prevention (CDC) recommends receive the vaccine first: pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months through 24 years, and people ages 25 through 64 years who have chronic health disorders or compromised immune systems.

Effective Oct. 1, 2009, BCBSIL recognizes the following codes for administration of the H1N1 vaccine:

G9142 - Influenza A (H1N1) vaccine, any route of administration

G9141 - Influenza A (H1N1) immunization administration (includes the physician counseling the patient and family)

Though this vaccine is being supplied by the federal government to providers free of charge, a fee for administering the vaccine may be allowed, depending on the patient's benefit plan. Services will be subject to deductible, copayment and coinsurance, as applicable.