Pharmacy Vaccination Program

Vaccines are an essential part of maintaining a person’s health and vitality. To maintain wide access to vaccines, it’s critical that pharmacies are reimbursed appropriately for the breadth of services they provide when administering those vaccines.

We are updating the program’s vaccine administration fees.

The vaccine administration fee, which includes the costs of the pharmacists’ time to administer the vaccine, specialized training, refrigeration, and ancillary administrative paperwork, is being updated to account for the below market dynamics and trends:

• Rising inflation
• Pharmacist capacity
• Ongoing maintenance and inventory storage requirements that result in more stringent inventory controls
• Increased vaccine hesitation, requiring additional consulting time between the pharmacist and members

The following vaccine fee updates will go into effect January 1, 2025: 

• Influenza vaccine claims will be capped at $20
• COVID-19 vaccine claims will be capped at $40
• All other vaccine claims will be capped at $25

Covering vaccinations at retail pharmacies for your members can help:

• Improve affordability by saving an average of $70 on common vaccines when administered at the pharmacy vs. at a physician’s office.
• Increase convenience as members are likely already spending time at the pharmacy picking up prescriptions and other necessities.
• Reduce stress for your members by allowing them to continue to receive their vaccinations at their local pharmacy.

This update reflects our shared commitment to making vaccines accessible and affordable while ensuring participating pharmacies are reimbursed for their time and expertise, so they are empowered to provide these critical services.

To opt-out of the updated pricing structure for vaccines, fill out the fields below. Opt-out via this website will close on December 9, 2024. Should you choose to opt out this update, please contact me to discuss next steps as this update is critical for future program participation.