Will Blue Cross Insurance, Illinois cover Gardisil?

Question

does anyone know how much it will cover, if any?

Answer 1

yeah

Answer 2

Most plans do. You really need to call them... (If you have coverage for vaccines, & between 9 & 26 yrs old)

Call them first!!! Each plan is different.

Answer 3

it depends

Answer 4

The answer to this, and other similar questions, can be found by looking for the "formulary" that is used by a particular insurance company. The formulary shows what drugs are included in the various plans, and the coverage "level" for that drug.

According to the BCBS Illinois formulary (which I've linked below), Gardasil is covered as a "Level 3 co-pay" brand. I'm not sure that that means exactly, but I'm sure it refers to the amount of your co-pay that you're responsible for. In this case, a Level 3 co-pay looks like it might be more expensive than a Level 2.

I hope this is what you were looking for. Good luck!

Answer 5

Lately, most plans (with the exception of BCBS of Michigan and some small unions) are paying for Gardisil - most have just a copay on it. You can call your plan specificially - especially with larger plans, many employers pick what they cover and what they don't cover - but what the insurance says and does are sometimes two different things. (It's their disclaimer "Actual benefits are determined when a claim is received")

Since IMO Gardisil is an important vaccine, what you can do is ask the doctor's office for a contigency plan - meaning if your insurance doesn't pay for it, can they discount it for you and let you make payments? OR help you appeal the denial. (It is an expensive shot - it costs the doctor's office about $120 a dose to purchase)

Answer 6

Most insurance companies do not cover vaccinations outside of the 'standard' infant approved ones such as measles, mumps, chicken pox, etc.  On occasion they'll cover other preventative medicine such as flu shots, but that is rare.  

So the answer is PROBABLY no, although I am not familiar with how this vaccination is administered so if you're able to have it dispensed to you by a pharmacy with a physicians prescriptions its possible that they'll cover it AS a prescription but i doubt it.  

In the end you'll have to call your customer service department at the insurance company to ask them.  When they tell you know I'd suggest calling your union - if you're a union member :)

(I used to work at blue cross, but not in illinois.)