As the nation braces for the impact of a likely H1N1 pandemic this fall, insurance companies covering Pennsylvania residents and those nationwide are taking steps to cover the administration of a vaccine.

Philadelphia-based Independence Blue Cross announced last month it would cover both the H1N1 and seasonal flu vaccination for all of its members with the mission of keeping policyholders “healthy and flu-free” this year.

I. Steven Udvarhelyi

I. Steven Udvarhelyi, IBC’s senior vice president and chief medical officer, said in a statement that the insurer is monitoring the spread of both viruses and will follow recommendations from the Centers for Disease Control and Prevention as well as federal, state and local governments.

“At Independence Blue Cross, we want our members and customers to be prepared with everything they need to know about H1N1 and seasonal flu to keep their families and employees healthy,” he said.

IBC spokeswoman Ruth Stoolman added that the insurer’s motive for complete coverage is “not financially-driven,” but rather to keep its members healthy. She added that the company felt no pressure to provide widespread coverage from other insurers in the region and nationwide taking similar steps.

Pennsylvania’s other big Blue, Pittsburgh-based Highmark, said it will cover “100% of our insured business, regardless of whether they have the preventive benefit [in their health plan] or not,” according to spokesman Phil Neubauer.

Neubauer said projected costs to Highmark had yet to be determined and the insurer is working on a communications plan for all of its stakeholders.

“Obviously, we expect significant numbers of our group customers, agents and individual members to call us with questions,” he said.

Coverage conditions

Harrisonburg, Pa.-based Capital BlueCross said it would also cover the administration fee for fully insured members and those with individual coverage.

Horizon Blue Cross Blue Shield of New Jersey said its standard policy is to pay for approved vaccines and administrations, as it will with H1N1 for those customers with preventative health benefits.

Blue Cross Blue Shield of Delaware said it would cover those members recommended by the CDC to receive the H1N1 vaccine such as pregnant women and those between the ages of 6 months and 24 years, regardless of preventative health benefits as part of their plan.

UnitedHealth Group was one of the first national health insurers to say it would cover the administration of the H1N1 vaccine.

The insurer has said it will cover the fee not only for members whose health benefit plans cover immunizations, including those in Pennsylvania, but all of its members, regardless of whether it is part of their plan.

Tyler Mason, a spokesman for the insurer, told IFAwebnews.com the company has set aside $50 million to cover H1N1 vaccinations.

“We felt it was important to remove barriers to ensuring the widest possible administration of the vaccine,” Reed V. Tuckson, executive vice president and chief of medical affairs for the Minneapolis, Minn.-based company said in a statement.

National insurers Aetna and CIGNA said they too will be covering the administration of the H1N1 vaccine to their Pennsylvania customers.

Aetna spokeswoman Wendy Morphew said the company will cover members with health benefit plans that provide vaccination coverage, indicating that “most” Aetna members have such coverage.

A CIGNA spokesperson said the company will cover the H1N1 vaccine under the preventative care benefit for all members, meaning “75 to 80% of our membership will be covered 100% without co-pays or insurance.”

All three companies said they are conducing public outreach through a variety of means to inform policyholders.

For an essay on pandemics preparedness by two of CIGNA’s business managers in the insurers’ international benefits division, click here.

This story originally appeared in the October 2009 print edition of Insurance & Financial Advisor.