CENTERS FOR MEDICARE & MEDICAID SERVICES
Medicaid and the Children’s Health Insurance Program (CHIP) Coverage of the 2009 H1N1 Flu Vaccine and Treatment The 2009 H1N1 flu (sometimes referred to as “swine flu”) is caused by a new strain of influenza virus. It is causing illness in people. The virus spreads from person-to- person, probably in much the same way that regular seasonal flu viruses spread.
The symptoms of the 2009 H1N1 flu are similar to the symptoms of regular seasonal flu. These symptoms include fever, cough, sore throat, runny or stuffy nose, body aches,headache, chills, and fatigue. A significant number of people who have been infected withthe 2009 H1N1 flu virus also have reported diarrhea and vomiting. If you have flu-like symptoms, call your doctor’s office right away. Is there a vaccine for the 2009 H1N1 flu, like there is for the seasonal flu? Yes. The initial doses of the 2009 H1N1 flu vaccine are currently available for those at highest risk for infection. Additional doses are scheduled for shipment each week. Who should get the 2009 H1N1 flu vaccine? There are some groups of people who have a higher risk of getting the 2009 H1N1 flu than others. Therefore, the Centers for Disease Control and Prevention (CDC) has recommended that the following groups get their vaccine as soon as it becomes available in their area: • Pregnant women • People who live with or care for children younger than 6 months of age • Healthcare and emergency medical services personnel • Persons between the ages of 6 months through 24 years • People ages 25 through 64 years who are at higher risk because of chronic health
Who should get the 2009 H1N1 flu vaccine? (continued)If you aren’t in one of the groups listed above, talk with your doctor about when toget the vaccine. Note: If you are sick and need to be in close contact with someone who has a higher risk of getting the 2009 H1N1 flu, consider wearing a surgical mask or cover your nose and mouth with a tissue. Remember to wash your hands frequently. Will Medicaid and the Children’s Health Insurance Program (CHIP) cover the 2009 H1N1 flu vaccine? Yes. Medicaid and CHIP cover the 2009 HIN1 flu vaccine.
Medicaid and CHIP will cover both a single dose of the seasonal flu vaccine and one ormore doses of the 2009 H1N1 flu vaccine, if more than one dose is needed. Talk toyour doctor to find out how many doses you will need.
Children and pregnant women will get the vaccine free of charge. Adults are covered ifthey get the vaccine at a public health department, physician office, Federally-qualifiedhealth center, or rural health clinic, but they may have to pay a small copayment.
You may get the vaccine at a hospital, but it’s only recommended if you can’t get toanother site.
Your state is working with your local public health department to make it easy for youto get a vaccine. To find the most convenient site for you, call or visit your state’s publichealth department Web site. A listing of state public health departments can be foundb
What if I get the 2009 H1N1 flu? Contact your doctor for advice on how to treat the 2009 H1N1 flu.
Medicaid and CHIP will cover your care, including an evaluation, any required tests,and your treatment. Children under 18 and pregnant women will get care free-of-chargewhile other adults may have to pay a small copayment.
There are drugs your doctor may prescribe for treating both seasonal and H1N1 flucalled “antiviral drugs.” These drugs can make you better faster and may also preventserious complications. This flu season, antiviral drugs are being used mainly to treat people who are very sick, such as people who need to be hospitalized, and to treat sickpeople who are more likely to get serious flu complications. Remember, most peoplewith the 2009 H1N1 flu have had mild illness and haven’t needed medical care orantiviral drugs, and the same is true of seasonal flu.
What if I get the 2009 H1N1 flu? (continued)
Some states have preauthorization requirements for antiviral medications, such asTamiflu or Relenza. This means that the prescription must be approved by the Statewhere you live. This approval process can take 24 hours. If you are prescribed an antiviral medication, you are entitled to get at least 3 days worth of the prescriptionright away. The CDC recommends a full 5-day course of antiviral medication, so if youare unable to get 5 days worth of the prescription right away, make sure to go back tothe pharmacy after 24 hours to pick up the rest.
Where can I find more information about the 2009 H1N1 flu, including how the virus is spread and how to prevent it? For morDisease Control WYou can also call 1-800-CDC-INFO (1-800-232-4636) for more information. Where can I find out more about Medicaid or CHIP? Call your State Medical Assistance (Medicaid) office for more information. Call 1-800-MEDICARE (1-800-633-4227) and say “Medicaid” to get the telephone number for your State Medical Assistance office. TTY users should call 1-877-486-2048. You can
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