November 22, 2021
Starting Jan. 1, 2022, Blue Cross and Blue Shield of Illinois (BCBSIL) will cover the cost of COVID-19 vaccines and their administration for Blue Cross Medicare Advantage HMOSM (MA HMO), Blue Cross Medicare Advantage PPOSM (MA PPO) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM members instead of the Original Medicare program (also known as fee-for-service Medicare). MA (HMO and PPO) and MMAI members will continue to have no cost-sharing during their 2022 benefit year for COVID-19 vaccines and their administration, including approved booster doses.
What This Means for You
- Through Dec. 31, 2021: For MA (HMO and PPO) and MMAI members you vaccinate through December 31, submit claims for the vaccine and its administration to the Centers for Medicare & Medicaid Services (CMS) Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved. Payment for the vaccine and its administration is through the Original Medicare program until the end of the year.
- Starting Jan. 1, 2022: For MA (HMO and PPO) and MMAI members you vaccinate on or after January 1, follow your normal submission process to BCBSIL or call the number on the member’s ID card for billing instructions when submitting vaccine and administration claims.
- In-network providers will be reimbursed for the COVID-19 vaccine and administration fee based on contracted rates.
- Out-of-network providers will be reimbursed based on established out-of-network reimbursement policy that follows Medicare rates.
- Learn more about COVID-19 coverage
- See CMS guidance on Medicare billing for the COVID-19 vaccine administration