The vaccine for H1N1 (swine flu) is expected to be available in October, and the country is gearing up for the fall flu season. What is Aetna is doing, and how can your own organization prepare?

H1N1 and Seasonal Flu Vaccines
Aetna will cover H1N1 flu vaccine administration for members whose benefit plan covers preventive services, just as we have always covered the seasonal flu vaccine. We will pay for one or two doses of the H1N1 vaccine, based on recommendations of the Centers for Disease Control and Prevention (CDC).

The federal government will pay for the H1N1 vaccines and the supplies needed to administer them. Aetna will reimburse providers for administration of the vaccine.

State and local public health departments will designate which public and private sites will be given the vaccine. Public sites could include public health clinics and clinics located in schools. Private sites could include provider offices, workplaces or retail settings. Aetna is encouraging participating providers to register with their state’s Department of Health to become vaccinators. A number of retail sites, including Minute Clinics/CVS, Take Care Health, and RediClinics, also are expected to be vaccinators. We will encourage our members to seek vaccines at any of these available outlets (note that emergency rooms are not the appropriate place to seek vaccines).

Employers can seek to be designated by their state or local public health department as vaccinators and have vaccine shipped to them, or they can hire a commercial designated vaccinator that will provide the vaccine on-site. We expect that at least some of the corporate seasonal flu shot vendors used by Aetna will be able to offer H1N1 vaccines at employer worksites, but this may vary by state. We can share more information on this once the vendors are able to register and be designated as vaccinators by the states.

It is expected that each person will need to have two H1N1 vaccines, three to four weeks apart. A separate vaccine is needed for the seasonal flu.

Primary target groups for H1N1 vaccination will be:

  • Pregnant women
  • Contacts of infants <6 months old
  • People 6 months to 24 years old
  • Health care workers/emergency personnel
  • Adults under 65 years old with high-risk medical conditions
    • The next group after this is healthy adults 25-64 years old
    • The final group is adults 65 and older
    • Aetna will rely on providers to make determinations about when an individual should receive the vaccine, in accordance with CDC guidelines.

Should any of your plan members become ill, we treat H1N1 as any other disease under all of our plans. We do cover the prescription drugs Tamiflu and Relenza, which can be used to treat the H1N1 virus.

Updated Guidance for Businesses and Employers

Your own organization is probably working to ensure it has its own plans in place to deal with H1N1. Updated federal guidelines offer businesses and employers a range of options for responding to 2009 H1N1 influenza, depending on how severe the flu may be in their communities. The guidance says business planners should assess their business functions to determine the threshold of absenteeism that would be potentially disruptive and plan ahead to take increasing measures as absenteeism escalates toward those thresholds. More information and helpful communications for employers are available at:

If you would like information on Aetna’s business continuity planning, please see our Overview of Aetna’s Preparedness for Pandemic. This section of the employer site on aetna.com includes a high-level look at Aetna’s business continuity plans for a pandemic, as well as frequently asked questions on our preparations and a list of resources.

SHARE