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).
The CDC recommends that:
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 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**:
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.
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|
Visit the links below for additional information and resources regarding influenza prevention and treatment.
Contact your UnitedHealthcare representative.