Monday, August 24, 2009

Laudable Carrier Trick, Swine Flu Edition

"Even a blind squirrel finds a nut now and then" goes the adage, and once again, we have a case of a carrier "doing the right thing." From email:
"UnitedHealthcare will provide coverage for the administration of the H1N1 (swine flu) vaccine for all members covered by its fully insured plans.
We intend to process all self-funded member claims as a covered service unless clients explicitly direct us otherwise. If your client's plan does not currently cover the administration of the vaccine, and you notify us of your client's intent not to cover the vaccine in the future, UnitedHealthcare will reimburse the cost of the administration of the vaccine. The federal government has said that the vaccine will be provided at no cost to health care providers."
The note goes on to say that UHC will be working with appropriate authorities to make sure as many folks as possible have access to the vaccine.
The reference to self-funded (aka ERISA) plans is interesting, as well. Most folks don't know this, but ERISA plans are pretty much free to cover and exclude benefits as they see fit. So if a plan either doesn't specifically cover, or if it specifically excludes, the cost of these vaccines, the carrier (UHC in this case) really has no justification for paying or reimbursing for that expense. If you work for a company which has such a plan, it'd be worth your while to check with HR about how (or even if) the vaccine is a covered expense.
Whether or not it is, if you have an HSA, FSA or HRA plan, my Flexible Benefits Guru Pete Deist says that the cost is "probably" reimburseable under that, so your own out-of-pocket may be reduced. The reason for that qualifier, by the way, is that it's not specifically mentioned as either eligible or ineligible, so we really don't know for sure.
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