December 15, 2022

Influenza prevention and treatment resources

Flu season is upon us once again, making it a great time to review the latest information and resources regarding influenza prevention and treatment. To help, we’ve assembled an overview of the current clinical guidelines for influenza prevention and treatment from the Advisory Committee on Immunization Practices (ACIP) and the Center for Disease Control and Prevention (CDC).

Preventive therapy

The CDC recommends that:

  • People younger than 65 years may receive any age-appropriate influenza vaccine. Options include inactivated influenza vaccine [IIV], recombinant influenza vaccine [RIV], or live attenuated influenza vaccine (LAIV), with no preference for any vaccine over another.
  • For people 65 years* and older, there are 3 flu vaccines that are recommended over standard dose, unadjuvanted flu vaccines. These are Fluzone® High-Dose Quadrivalent vaccine, Flublok® Quadrivalent recombinant flu vaccine and Fluad® Quadrivalent adjuvanted flu vaccine. These are new recommendations - Please refer to the CDC for additional information.

For patients at high risk of complications from the flu, please refer to the CDC for additional information. Full details of the CDC recommended vaccination schedule are also available for review.

Influenza (Flu) vaccine coverage

Influenza vaccines are generally covered under UnitedHealthcare preventive health services and will typically cost members $0 out of pocket.

For more specific information, please refer to the following benefit policies**:

Treatment therapy

The CDC recommends prompt treatment (within 48 hours) with antiviral therapy for people who have the flu or suspected flu and who are at higher risk of serious flu complications. Clinicians can consider empiric antiviral therapy for non-high-risk patients with suspected influenza-like illness if treatment can be initiated within 48 hours of onset.

  • Patients with complications or progressive disease and suspected/confirmed influenza, oral oseltamivir (Tamiflu®) is recommended as soon as possible.
  • Patients with suspected or confirmed uncomplicated influenza, oral oseltamivir (Tamiflu®), inhaled zanamivir (Relenza®), or oral baloxavir (Xofluza®) may be used for treatment.

Influenza antiviral therapy coverage

The table below outlines coverage guidelines for the various antiviral therapy options.

Formulary oseltamivir capsule/suspension zanamivir diskhaler (Relenza) baloxavir (Xofluza)
Commercial Prescription Drug List Tier 2 Tier 3 Tier 3
Medicaid Core Preferred Drug List Preferred Preferred Non-preferred
Medicare Prescription Drug Programs (PDP)^ Tier 3 Tier 3 Tier 3
Individual Exchange Plans^^ Tier 3 Tier 4 Tier 8

Additional resources

Visit the links below for additional information and resources regarding influenza prevention and treatment.


Contact your UnitedHealthcare representative.

* Recommended for those age 65 years and older
**Policies not listed for a specific benefit type are not currently available. 
^Applies to Medicare Advantage Part D Prescription Drug Program (PDP), Medicare PDP Preferred, Medicare PDP LCE “Walgreens” and Medicare PDP Saver. 
^^ Applies to all states with Individual Exchange Plans except for Colorado and Washington
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