United Healthcare of Nevada
UnitedHealthcare, working in concert with public health authorities, providers and others, is taking a number of steps to reduce or eliminate barriers to H1N1 immunization. They are also developing educational materials based upon guidance from the Centers for Disease Control and Prevention (CDC) to help enrollees stay informed.
Coverage for the Vaccine
UnitedHealthcare will cover the administration of the H1N1 vaccine for all fully insured members, with no copays, deductibles or coinsurance fees. For self-funded clients, including those that exclude immunization coverage, they intend to process all H1N1 vaccine administration claims as a covered service, with no copays, deductibles or coinsurance fees, unless directed otherwise by the client by Oct. 12, 2009. Based on direction from the CDC, we will be paying the physicians based on Medicare approved rates (based on MSA) or billed charges, whichever is lower.
For Health Maintenance Organization (HMO) clients, please instruct your members to consult with their primary physicians to receive the H1N1 vaccine.
Vaccine Distribution and Availability
The H1N1 flu vaccine is being distributed to each state by the federal government. Every state is developing a vaccine delivery plan, which will likely include a combination of physician offices and non-traditional settings. UHC has worked diligently with a number of partners to ensure that UnitedHealthcare members have a broad range of options from which to select to get the H1N1 flu vaccine:
- Public Health Clinics: Members may be able to receive their H1N1 vaccine at most local public health clinics at no cost or at a federally subsided rate.
- Doctor’s Office: The cost of the vaccine, needles, syringes, alcohol swabs and sharps containers will be fully paid for by the U.S. government. UHC will cover the administration of the H1N1 vaccine for all fully insured members, with no copays, deductibles or coinsurance fees. For self-funded clients, we intend to process all H1N1 vaccine administration claims as a covered service, with no copays, deductible and coinsurance fees, unless directed otherwise. HMO members should consult with their primary physician to receive the H1N1 vaccine.
- Retail Pharmacies: Members will be able to have the H1N1 vaccine administered at several major retail pharmacy chains. There’s no up-front cost to the member, if they choose this option. Participating pharmacies will submit a nominal fee to us for administering the vaccine. UHC will fully cover this fee for all insured members and debit self-funded client accounts accordingly.
A list of public health clinics and participating pharmacies will be posted on UnitedHealthcare.com and myuhc.com, starting later this week and will be updated regularly. Members should be encouraged to call to ensure that the pharmacy has the vaccine and is participating in the UnitedHealthcare program.
Priority Populations
The CDC has prioritized the following high risk population segments to initially receive the vaccine, with others to follow as the vaccine becomes more widely available:
- pregnant women;
- caregivers for children younger than 6 months of age;
- health care and emergency medical services personnel;
- children and young adults from 6 months through 24 years old; and
- persons aged 25 through 64 years who have underlying health conditions that might increase their risk for flu-related complications.
H1N1 Member Materials and Support
UHC is taking action to assist all UnitedHealthcare members, especially those identified by the CDC as being at a greater risk for complications from the H1N1 flu. An employee communication template outlining a variety of member resources, including links to our dedicated H1N1 information section on our Web site, Frequently Asked Questions, an audio webinar on H1N1 and more is included. UHC is strongly encouraging you to customize and share this communication with your employees.
In addition they are taking the following actions:
- Targeted Outreach to High Risk Populations: Working closely with our care management team, we are launching a targeted campaign to reach out to members in populations prioritized for immunization identified by the CDC, such as pregnant women and those with underlying health conditions.
- NurseLineSM: Their Care24® NurseLine and Maternity NurseLine (offered through the Healthy Pregnancy Program and the Maternity Support Program) clinicians have been fully trained to address questions related to H1N1 flu, especially how it relates to pregnant women, children and other at-risk populations. These services are available for those who have these benefits.
- Customer Care: Their customer care professionals are ready to assist members and can be reached at the toll-free number on the back of their member ID card.
Business Continuation Preparedness
United Healthcare wants to reassure clients that if this situation escalates, they are fully prepared to initiate our business continuation program, which is designed to minimize any type of service disruption.
For More Information
Enclosed is a list of frequently asked questions, with additional details on their actions. For the most up-to-date clinical guidance, please visit www.cdc.gov/h1n1flu.
You may also contact us for questions specific to your United Healthcare Group Policy.
