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1993.09.30 :  Medicare Coverage for Flu Shots

Contact: Duke Sybor, HCFA (202) 690-8056
          Bill Grigg, PHS (202) 690-6867
September 30, 1993

     HHS Secretary Donna E. Shalala said today that older
Americans can avoid a life-threatening flu this year by using a
new Medicare benefit that pays for flu shots.
     At the same time, she said, the Centers for Disease Control
and Prevention is recommending earlier-than-normal inoculations
for flu this year.  The CDC recommendation is included in an
article to be published by the agency Friday.
     "The elderly are especially vulnerable to potentially severe
effects of influenza," Secretary Shalala said at a press
conference today.  "We are launching a comprehensive campaign
urging all senior citizens to receive shots before the flu season
hits in late fall.  For most seniors, vaccinations will be free,
since Medicare now covers flu shots."
     Secretary Shalala was joined at the press conference by a
coalition of organizations participating in the flu shot outreach
campaign.  These include the National Coalition for Adult
Immunization, National Foundation for Infectious Diseases, the
American Association of Retired Persons, the American Lung
Association and the American Medical Association.
     The Public Health Service reports that more than 10,000
Americans die in many flu seasons, and some years the number of
deaths reaches 45,000.
     Because influenza viruses change from year to year, the
vaccine is updated every year.  This year, vaccine is available
to combat a strain of Type A Beijing flu that is expected to
affect the United States this winter.  
     CDC normally recommends receiving flu shots between mid-
October and mid-November.  However, in Friday's edition of
Morbidity and Mortality Weekly Report, the agency will recommend
that the optimum time for inoculations for the elderly is now
through the end of October.  Earlier inoculation is recommended
because of the possibility of an early flu season.
     The new coverage of annual flu shots is available for
elderly and disabled persons enrolled in Medicare Part B, which
covers medical services.
     Bruce C. Vladeck, administrator of the Health Care Financing
Administration, said Medicare reimburses for the flu vaccinations
when furnished by physicians or clinics that accept Medicare
assignment.  Beneficiaries will not be charged for the part B
deductible or for the normal 20 percent coinsurance payments for
medical services.
      Physicians who accept assignment accept Medicare approved
amounts as full payment for their services.  Physicians who do
not accept assignment can impose charges in excess of the
Medicare rates for the flu shots.
     Philip R. Lee, M.D., HHS assistant secretary for health and
head of the PHS, urged Medicare beneficiaries who have never had
pneumonia shots to get them also when they receive their flu
shots.
     The pneumonia shot is usually needed only once in a lifetime
and can be obtained free or at reduced cost by Medicare
beneficiaries. The payment policy is the same as that for the flu
shots.
     The Centers for Disease Control and Prevention in Atlanta
works with the World Health Organization annually to spot the
emergence of the next year's strain of flu.  CDC and the Food and
Drug Administration cooperate with private manufacturers in
developing a vaccine that will protect against the virus.  About
50 million doses have been manufactured and are available
throughout the United States this year.
     A consumer leaflet, "Medicare Pays for Flu Shots," is
available from the Medicare Issues Hotline, toll-free, 1-800-638-
6833.