There are good reasons flu shots are included as part of essential health benefits for qualified health plans. It just makes sense.
Look at the numbers that the Centers for Disease Control and Prevention show as the likely preventive value of flu shots nationwide.
What Does No Charge Mean?
Flu shots are available for members with qualified health plans at no out-of-pocket cost at any in-network provider office or in-network clinic.
There is no cost even if the flu shot is given during a visit that is not an annual wellness visit. You would just owe whatever copay your plan requires for the rest of the visit.
PPO members who get flu shots at an out-of-network provider office or clinic would owe some percent coinsurance of any charge for the shot. The percent varies by plan.
For HMO members, flu shots are not covered at out-of-network providers or clinics.