Wednesday, March 22, 2023

Is Hpv Vaccine Covered By Blue Cross Blue Shield

What Can You Do To Protect Yourself

Blue Cross RI ending no-cost coverage for COVID-19 treatment

Cervical cancer is not just a treatable diseaseits preventable. It can develop relatively slowly over time, making early detection of cervical pre-cancers the best way to treat it.

The HPV vaccine is for girls and boys, and adults. Talk to your provider and your childrens provider about an HPV vaccine to help minimize the risk of cervical cancer.

  • Children should receive two shots of HPV vaccine at least 6 months apart at ages 11 or 12, finishing the two-shot series before their 13th birthday.
  • Teens and young adults who did not start the HPV vaccine series before they turned 15 will need three shots within six months for best protection.
  • Teens, young adults, and women through age 26 who have not received the HPV shots should ask their doctor or nurse about getting them now.
  • Adults age 2745 should talk with their doctor about the HPV vaccine and if its necessary for them.

The HPV vaccine does not replace the need for regular Pap tests and pelvic exams.

If you’re an adult woman, schedule a yearly exam with your primary care provider, OB/GYN, or other health professional.

  • Women who are age 21-29 should have a Pap test every three years.
  • Women age 30-65 should have a co-test every five years or a Pap test alone every three years.

Adhere To Human Papillomavirus And Shingles Vaccine Guidelines

Timely vaccinations can help protect your patients health. For patient safety, its important that you follow the U.S. Food and Drug Administration guidelines and the Advisory Committee on Immunization Practices recommendations and child and adult immunization schedules.

How are claims affected?

Blue Cross and Blue Shield of Illinois reviews claims to ensure applicable guidelines are met. Weve found that two categories of vaccines are often administered outside FDA and ACIP recommendations: those to prevent HPV and those to prevent shingles caused by the herpes zoster virus.

For these categories, if vaccines are administered outside of the FDA and ACIP recommendations,

BCBSIL will:

  • Consider the services to be experimental, investigational or unproven , which are not a covered benefit for BCBSIL members and
  • Recover reimbursements as per the claim payment recovery process outlined in our participating provider contracts.

BCBSIL will continue to reimburse medically necessary claims for vaccines administered according to FDA approval guidelines and ACIP recommended schedules.*

Know the Facts: HPV Vaccination

Gardasil 9 is the vaccine for the prevention of HPV infections and associated diseases, including oropharyngeal and other head and neck cancers.

Know the Facts: Shingles Vaccinations

Shingrix and Zostavax help prevent shingles and its complications:

More Information

**BCBSILs CPCPs dont apply to members who have Medicare or Medicaid plans.

Find Blue Cross Blue Shield Medicare Plans That Cover Vaccines And More

To learn more about the BCBS Medicare plan options available in your area, contact a licensed insurance agent. Remember, most Medicare Advantage and Medicare Part D plans will typically cover the same set of vaccines, so there may be additional benefits or costs to consider when choosing between plans.

Recommended Reading: Cvs Tdap Shot

Blue Cross Blue Shield Decides To Cover Hpv Vaccine In Males

Blue Cross Blue Shield of Massachusetts announced today that it will start covering the human papillomavirus vaccine for males. As I reported last month, the insurer had refused to cover the nearly $400 cost of the three shots required for full protection against the virus which causes cervical cancer in girls and anal and throat cancers in both genders.

The US Food and Drug Administration has approved the HPV vaccine for teenage boys and men up to age 26, but the federal Centers for Disease Control and Prevention says males may get HPV vaccine but doesnt recommend it. The CDC does, however, recommend the vaccine for girls, and Blue Cross covers the cost of the immunization in them.

It is our understanding that the CDC is expected to recommend the use of this vaccine in males at its October meeting, Blue Cross Blue Shield spokesman Jay McQuaide said in an e-mail. In anticipation of the CDC taking this expected step in October, we are beginning the process to cover the vaccine in males.

He added that the action was based on the companys normal business practice and unrelated to the Globe story.

Males with Blue Cross Blue Shield coverage must ask their doctors to submit a request for individual consideration to obtain coverage for the vaccine, and the insurer said the requests would be reviewed and routinely granted, with exceptions made for those with serious health conditions or who fall outside the recommended age range.

Many Private Insurance Plans Reimburse Some Or All Of The Cost Of Gardasil9 Find Out If Your Plan Does

HPV: Why it

If you have a drug benefit wallet card, simply present your card to a pharmacist along with the Drug Identification Number for GARDASIL®9 and ask if you are covered.

If GARDASIL®9 is not listed under your group benefits plan, it may still be covered under your health spending or wellness account, if applicable. Contact your group benefits plan Customer Service for details at one of the numbers below or visit the web site for your insurance provider.

Insurance Company*

You May Like: Tdap Shot At Cvs

Preventive Services For Commercial Members

Effective January 1, 2022, colorectal cancer screening will be covered as a preventive health service without cost sharing beginning at age 45. For details, please refer to the policy here.

We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex, including sexual orientation, gender identity, or gender expression. We also provide language assistance. Read our Nondiscrimination and Language Assistance notice.

All trademarks unless otherwise noted are the property of Blue Cross & Blue Shield of Rhode Island or the Blue Cross and Blue Shield Association. Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association.

Does Blue Cross Blue Shield Cover Vaccines

  • Blue Cross Blue Shield Medicare Advantage plans cover the same vaccines that Original Medicare covers, and some BCBS Medicare plans my cover additional vaccines that Original Medicare doesnt. Learn more about BCBS Medicare and the preventive health care these plans may cover.

Vaccines are an integral part of keeping infectious diseases at bay, and many Anthem Blue Cross Blue Shield plan members might wonder if their plan will cover their shots. Anthem BCBS is part of the Anthem family of brands.

Blue Cross Blue Shield health insurance and Blue Cross Blue Shield Medicare Advantage plans do indeed cover a wide range of vaccines. Below is a breakdown of what vaccines are covered by which BCBS plans.

You May Like: Cvs Tdap Vaccine Schedule

Where Can You Get Your Shots And Vaccines

If you have health insurance, choosing an in-network provider or a retail clinic that participates in your insurance plan can help you keep costs lower. You can get shots from an out-of-network provider, but you may be asked to pay the full price.

If you have a CareFirst health insurance plan, learn more about what vaccines are covered in the Summary of Preventive Services or ask Member Services any questions you may have.

If you are a member of another health plan, or are comparing available benefits, ask your health insurer’s Member Services office what vaccines are covered with your health insurance.

You Are About To Leave Gardasil9ca

How insurance works with COVID vaccine

You are now leaving, a Merck Canada Inc. website, and will be directed to the Dialogue Technologies Inc. website.This link is provided for your convenience only. Merck Canada is not affiliated with Dialogue and does not endorse, nor is responsible for the content of the Dialogue website. Merck Canada makes no representation as to the accuracy or completeness of any information available through this or any subsequent link, or regarding any information communicated by healthcare professionals through the Dialogue website. Merck Canada will have no access to personal information communicated to Dialogue or to any healthcare professional through the Dialogue platform. All medical decisions, which may include the selection of appropriate prescription medicines, shall reside only with the independent healthcare professional. Merck does not exercise any control over the acts of the independent healthcare professionals with whom you may communicate through the Dialogue website.This HPV virtual consultation is supported by Merck Canada.

How you can get GARDASIL®9

Safety information

HPV=human papillomavirus.

Heres an example of the e-mail you will send:

Hi, < recipient’s name> !

One really important fact I learned is that GARDASIL®9 is the first and only vaccine indicated for the prevention of infection by 9 HPV types. These HPV types cause approximately 90% of cervical cancer cases and 90% of genital warts.

< recipient’s name>

Recommended Reading: Can I Get Tdap At Cvs

A Vaccine To Prevent Cancer Hpv Vaccine

Most parents know about the vaccines for the flu, measles, mumps and rubella and polio. But many parents may not know about a newer vaccine to help prevent certain kinds of cancer.

This vaccine, the human papillomavirus vaccine, is recommended for boys and girls of middle school age, before they are even exposed to the virus. Heres why.

HPV causes common genital infections and is transmitted through sexual contact. More than 80 percent of sexually active individuals will be infected with at least one type of HPV in their lives. A person who has had only one partner can get an HPV infection.

Most HPV infections go away within one to two years and do not cause cancer. Some people dont even realize they are infected. However, some HPV infections can lead to certain types of cancer.

The HPV vaccine is very effective in preventing HPV infections when given before a person is exposed to the virus. This means it should be given before a person is sexually active.

New Members Can Get Vaccines At Pharmacies

Effective immediately, members 18 years of age and older with pharmacy benefits can now go to a participating Express Scripts retail pharmacy to receive 11 different immunizations. Vaccines are covered with no cost share to the member and a prescription is not required. Previously, only the flu vaccine was available from a retail pharmacy.

The 11 vaccines are:

  • Polio
  • Shingles

In Massachusetts, the pharmacist must be registered and licensed to administer the vaccine. Since requirements vary in other states, members should contact their local pharmacy to confirm availability.

Your employees can continue to get their immunizations at their doctor’s office or at an outpatient clinic. The addition of the pharmacy option is intended to expand access to these preventive services. Employees should contact their pharmacy directly to confirm if a pharmacist is available to administer any of these vaccines.

This benefit applies to all Access Blue, HMO, PPO, POS, and indemnity plans with pharmacy benefits.

Recommended Reading: Tdap At Cvs

How Much Do Vaccines And Shots Cost With Insurance

Without health insurance, shots and vaccines are paid out-of-pocket. This means something like the shingles vaccine could cost you around $200 if you are uninsured.

With insurance, many preventive shots are covered, although you are still responsible for any copay or deductible your health plan has. The cost of vaccines and shots depends on two factors: the type of shot or vaccine, and your insurance coverage.

For Blue Cross Blue Shield plans offered by CareFirst, vaccinations are completely free. You will pay no out-of-pocket copayment or coinsurance, and you will not have to pay toward your deductible.

Parenting Vs The Hpv Vaccine

Independence Blue Cross reports growing uptake of HPV ...

Back to Blog Home > >

When it comes to the safety and well-being of our children, as parents were faced with a constant stream of decisions. Everything from organic foods to screen time to Does Little Johnny need to wear a sweater today? becomes a decision for parents to navigateand everyone seems to have an opinion.

In the age of social media and sharing, we can easily see other peoples thoughts and feelings about every topic under the sun. When a topic goes viral and is heavily debated, it can be hard to sort out fact from fiction. A perfect example of this is whether to immunize your child. And specific to vaccines, among the most passionately discussed is the human papillomavirus vaccine, commonly referred to as HPV.

Before I became a parent, I approached this topic solely as a nurse. The answer to me seemed so obvious: The vaccine prevents cancer, so why wouldnt any parent do this for their child? To be perfectly honest, I didnt understand what all the fuss was about. The universe has a sense of humor, though. The moment I became a mother, all that nursing stuff went out the window. I now saw the world through a completely different perspective. I now had a tiny human being depending on me for his survival and I didnt have a clue what I was doing!

Hang in there, moms and dads! At times the road through parenthood can get a little bumpy, but this beautiful journey is well worth it. #preventionmatters

Read Also: Tdap Shots Cvs

Blue Cross Blue Shield Association Study Shows Low Uptake Of Hpv Vaccine Compared To Other Adolescent Immunizations

Chicago While human papilloma virus vaccination rates have risen substantially, just 29 percent of adolescents received a first dose of the vaccine by their 13th birthday, according to a new seven-year study of medical claims by the Blue Cross Blue Shield Association Health of America Report.

First-dose HPV vaccination rates grew 55 percent among Blue Cross and Blue Shield commercially insured adolescent members from 2010 through 2016. Despite the growth, HPV vaccination lags behind meningococcal and Tdap vaccines, which have rates of 72 percent and 82 percent, respectively.

The study also finds that:

The report, Adolescent Vaccination Rates in America, examines outpatient medical claims for BCBS members born from 2000 through 2003 and who were vaccinated by their 13th birthday between 2010 and 2016.**

Just as its important for women to undergo a Pap smear for early detection of HPV infections, it is even more vital to prevent HPV infections before they happen, said Dr. Trent Haywood, senior vice president and chief medical officer for BCBSA. All adolescents should take advantage of this affordable medical innovation that prevents cancer and has minimal side effects.

– Concern for adverse side effects

– View that their child is not at risk, so the vaccine is unnecessary

– Did not have enough information about the vaccine

For more information, visit

Getting Shots And Vaccines With Your Health Insurance

Vaccines are important for protecting you from preventable diseases like measles, meningitis, and the flu. Vaccines prepare your immune system to fight diseases without making you sick, so that when you’re exposed to the real thing, you can save your days off of work for something more fun than lying in bed with a splitting headache and a burning throat.

Recommended Reading: Cvs Pharmacy Tdap

Collaborative Effort To Improve Hpv Vaccination Rates


Did you know that human papilloma virus vaccination rates fall far below those of other routine vaccines for adolescents across New York State ? Weve partnered with American Cancer Society, NYS and City Departments of Health and leaders of the state health care community to change that. This collaborative initiative, led by NYS HPV Coalition, is focused on increasing HPV vaccination rates among adolescents, ages 11 and 12.

As a provider, your endorsement matters. You are able to impact cancer prevention efforts by talking to parents and guardians about the importance of the vaccine and reducing the risk of HPV-related cancers. Research shows that the way you choose to introduce HPV vaccination makes a tremendous difference in outcomes. We encourage you to offer a presumptive, bundled recommendation, such as Your child needs three vaccines today: Tdap, HPV and meningococcal to prevent dangerous infections and cancer.

As you know, HPV infection is strikingly common, with 80% of people contracting HPV in their lifetime. Parents and guardians need to know that the HPV vaccine is safe and effective at preventing vaccine-type HPV infection. By increasing HPV vaccination rates in New York State, we can reduce the incidence of HPV-related cancers, including cervical, vaginal, penile, anal, and oral cancers, as well as genital warts. Please help us by educating parents and guardians about the importance of HPV vaccination.

Less Than One Third Of Children Are Fully Vaccinated Against Hpv Blue Cross Blue Shield Association Study Finds

Why that card from BlueCross BlueShield is important: 2 Wants to Know

Vaccines play a critical role in preventing the spread of serious viruses and diseases, and yet few children are fully vaccinated against human papillomavirus , according to a new study by the Blue Cross Blue Shield Association .

In a review of national claims data, 50% of children ages 10-13 received the first dose of the HPV vaccine between 2016 and 2019a vaccine that is proven to protect against infections that can lead to cancer later in life. Only 30% of those children received the second dose, which is required within 6-to-12 months of the first dose to reach full immunity.

HPV vaccine completion rates are growing much slower than the initiation of the first dose. Between 2016 and 2019, the number of children who received the first dose increased by 46%, while completion rates only rose 16%.Source: BCBSA

The Centers for Disease Control and Prevention recommends children and adolescents receive the HPV vaccine, which protects against sexually transmitted HPV infections that can lead to many cancers, including cervical cancer. While its estimated that HPV is responsible for 70-90% of cervical cancers and certain throat cancers in the U.S., vaccination rates remain significantly lower than other recommended vaccines for the 10-13 age group.

Also Check: Tdap Booster Cvs

When Do Blue Cross Blue Shield Medicare Plans Pay For Vaccines

All Blue Cross Blue Shield Medicare Advantage plans must provide all of the same coverage as Medicare Part A and Part B, which together are often called Original Medicare. Most Medicare Advantage plans also offer extra benefits like dental, vision, prescription drug coverage and more, all of which are not covered by Original Medicare.

Four vaccines are covered by Medicare Part B, which means Blue Cross Blue Shield Medicare Advantage plans are also required to cover them:

  • Flu
  • Pneumococcal
  • Hepatitis B

These shots are covered at no cost to the delivered at a Blue Cross Blue Shield network provider. Additional vaccines are typically covered if a plan member is exposed to a particular danger, such as a tetanus shot after stepping on a rusted nail.

BCBS Medicare Advantage plans that include prescription drug coverage may cover additional vaccines.

Medicare Part D prescription drug plans cover medications including additional vaccines not covered by Medicare Part B. Part D plans cover all commercially available vaccines, except those covered by Medicare Part B, when they are reasonable and necessary to prevent illness. Some of the vaccines that can be covered by a Blue Cross Blue Shield Part D plan include:

  • Shingles
  • Shingles
  • Tetanus

Popular Articles
Related news