• Why should I get the flu shot? According to the Centers for Disease Control and Prevention, during 2018 and 2019, the flu vaccine prevented 4.4 million influenza illnesses.It’s one of the most effective ways to prevent the flu and keep you and your family safe.
• Inpatient Copay for first 90 days of care during a 365-day period $1,364 Inpatient Copay for each additional 90 days of care during a 365-day period $682 Per Diem Charge $10/day.
• Cholera vaccine. COVID-19 vaccine. Diphtheria, tetanus, pertussis vaccine. Hepatitis A vaccine. Hepatitis B vaccine. Human papillomavirus (HPV) vaccine. Influenza (flu) vaccine. Japanese encephalitis vaccine.

Copay For Flu Shot

Covered Services

Costco limits the availability of the flu shot to Costco members and does not accept insurance. However, they will accept Medicare. Members not presenting their Aetna ID cards will be asked to pay at the time the flu shot is given. Maxim is charging the public $25.00 for the flu shot. Maxim does not give the flu shot to children under 9 years.

TRICARE covers the flu vaccine. The flu vaccine:

• Is an inactivated vaccine that contains a killed virus
• Causes antibodies to develop in the body to provide protection against infection
• Is recommended for all age groups 6 months to 64 years
• Has a high dose version available for those aged 65 years and older

Getting the Flu Vaccine

You can get the flu vaccine at no cost in three ways:

Military Hospital or Clinic

• Active duty service members have priority
• Call ahead to make sure it's available
• If not available stateside at your military hospital or clinic, you can seek the flu vaccine at a participating network provider or TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS.
• If not available overseas at your military hospital or clinic, you can seek the flu vaccine by:

Is There A Copay For Flu Shots

1. Getting a referral from your military provider and an authorization from the overseas regional contractor, and then seeing a civilian TRICARE-authorized provider for the flu shot at no cost; OR
2. Seeing a civilian TRICARE-authorized provider for the flu shot. You would pay the cost up front and then submit a claim for reimbursement.

• If you're an active duty service member, you need to follow your unit chain of command and service guidance for recording the vaccine in your service medical record

Participating Network Pharmacy

To find a participating network pharmacy:

• Call 1-877-363-1303

Call the pharmacy first to ask:

• What days and times can you get the vaccine?
• Are there any restrictions, including for children?
  • If your state has a restriction, you should go to your primary care physician or a military hospitals or clinic for the vaccine.

Note: The flu vaccine is covered by TRICARE with no cost-shares or copayments if it’s administered by a pharmacist at a participating network pharmacy or by a TRICARE-authorized provider at a participating network onsite clinic. You can still go to your doctor for the vaccine if the pharmacy has restrictions or it isn’t available. But, you may have to pay copayments or cost-shares for the office visit. You'll need to follow your plan's rules for getting care. This applies to all regions: East, West, and Overseas.

TRICARE-Authorized Provider

• Follow your plan’s rules for getting care
• You’ll need to pay your copaymentA fixed dollar amount you may pay for a covered health care service or drug. or cost-shareA percentage of the total cost of a covered health care service that you pay. for the office visit
• Active duty service members must have a referral to get the vaccine from any provider other than their primary care manager.

Are you an active duty or Guard/Reserve member?

You’re required to get the flu vaccine.

• You have priority to get the vaccine at military hospitals and military clinics.
• You can also get vaccines at participating retail network pharmacies.

If you go to a participating network pharmacy, you won't have any cost-shares or copayments if the flu vaccine is administered by a pharmacist. You can also go to a TRICARE-authorized provider at a participating network onsite clinic.

If you go to a network doctor other than your primary care manager (PCM), you must get a referral from your PCM. In addition, you may have to pay copayments or cost-shares for the office visit.

When you get a flu vaccine from a participating network pharmacy, follow your Service policy guidance for recording the vaccine in your shot record. You'll need the following information:

• The date the vaccine was given
• The vaccine name or code
• Manufacturer
• Lot number

TRICARE coverage for vaccines is based on recommendations from the Centers for Disease Control and Prevention (CDC). Visit the CDC website to learn more.

This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.

Last Updated 12/9/2020

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