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TRICARE announces changes to immunization policy

  • Published
  • By TRICARE
  • Public Affairs
In an effort to support non-active duty TRICARE Prime enrollees obtaining the H1N1 immunization, and avoid Point of Service charges, a temporary suspension of the requirement that the Prime enrollee obtain a referral from their Primary Care Manager to receive the H1N1 immunization from a non-network, TRICARE authorized provider is in place effective through April 30, 2010. 

This means that any non-active duty beneficiary can go to any TRICARE-authorized provider and receive the H1N1 vaccine, (must only receive this service during the encounter) without cost to them (after reimbursement). A referral from their PCM is not currently required.

Adequate vaccine is being produced to provide it to every citizen who desires immunization; however initial availability of the vaccine will be limited across the country so beneficiaries may still experience a delay in getting the H1N1 vaccine.

To protect those at highest risk, the following beneficiaries will have priority:
     - pregnant women
     - people who live with or care for children younger than 6 months of age
     - health care and emergency medical services personnel
     - persons between the ages of 6 months to 24 years
     - people ages 25 to 64 who are at higher risk for H1N1 because of chronic health
disorders or compromised immune systems

As long as the vaccine is obtained from a TRICARE-authorized provider, it will be covered by TRICARE. Pharmacists are not recognized by TRICARE as authorized to provide immunizations.

Flu shots administered in an authorized doctor's office are covered. Flu shots administered in a civilian pharmacy or drug store are NOT covered by TRICARE Standard, Extra, or Prime. However, some Convenient Care Clinics are available in high-traffic, retail-based locations that can include some retail pharmacies (e.g., CVS, Walgreen) and can provide flu shots. Even though they are in retail pharmacy locations, these CCCs are not considered to be part of the pharmacy.

You can locate CCCs and Urgent Care Clinics through Health Net's online provider directory or use the following links:

Minute Clinic

Concentra Urgent Care 

Take Care Clinic 

The Little Clinic  

Active duty members are not authorized to receive the H1N1 vaccine through civilian channels; they must use DoD-supplied stocks and follow DoD guidance.