Community providers: Providing flu shots to Veterans

It’s winter, and flu season is in full swing. Can you help us protect Veterans from the flu? If you are one of 70,000 retail pharmacies and urgent care providers who are part of our community care network, you can provide no-cost flu shots to eligible Veterans through May 31, 2022.

Here are five things to know when providing eligible Veterans with their no-cost shot:

1. Make sure you’re a retail pharmacy or urgent care provider that is part of VA’s Community Care Network (CCN).

• CCN Regions 1-3, administered by Optum^®/CVS Caremark^®, includes the following U.S. states and territories: AL, AR, CT, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NH, NJ, NY, OH, OK, PA, PR, RI, SC, SD, TN, VA, VI, VT, WI, WV. Contact Optum at 800-364-6331 to confirm you are in-network.
• CCN Regions 4-5, administered by TriWest Healthcare Alliance^®/Express Scripts^® includes the following U.S. states and territories: AK, AS, AZ, CA, CO, GU, HI, ID, MP, MT, NM, NV, OR, TX, UT, WA, WY. Contact TriWest at 800-922-1557 if you need to confirm you are in-network.

2. Check to make sure the Veteran is eligible for the benefit.

After checking the Veteran’s government-issued ID, ask for their 10-digit Veteran ID number, then check their eligibility electronically.

If you can’t check their eligibility electronically, call Optum at 888-901-6609 (Regions 1-3) or TriWest at 833-483-8669 (Regions 4-5) to confirm their eligibility. The system will indicate urgent care eligibility which includes flu vaccines.

If the Veteran doesn’t have or know their 10-digit Veteran ID number, ask for their Social Security Number (SSN), then call Optum at 888-901-6609 (Regions 1-3) or TriWest at 833-483-8669 (Regions 4-5) to confirm their eligibility. The system will indicate urgent care eligibility which includes flu vaccines.

To check their eligibility, Veterans can call 800-MyVA411 (800-698-2411), select option 1 (urgent care information), then select option 3 (urgent care information), and then option 1 again (to check urgent care eligibility). The system will check their eligibility for the community urgent care benefit, which includes the flu vaccine.

3. Don’t charge a Veteran eligible for this benefit any type of fee or copayment.

There is no charge for eligible Veterans to receive the flu shot through this benefit. However, if you are not part of VA’s network or the Veteran is ineligible for this benefit, VA cannot reimburse you for the cost of providing the flu shot.

4. Provide Veteran with documentation of their flu vaccination.

If you’re a retail pharmacy, please provide a copy of the flu vaccine documentation to the Veteran and recommend they provide it to their VA primary care provider’s office.

If you’re an urgent care provider, ask the Veteran for the name and location of their home VA Medical Center and please submit the flu vaccine documentation to that facility within 30 calendar days of the date of service.

5. Refer to our Billing Information Card if you need detailed billing information.

VA’ Billing Information Card has all the details you need to enter electronic billing information for this benefit, including phone numbers to call if you are having issues. Make sure to follow the directions for your CCN region, which is different depending on if you are in CCN Regions 1-3 (Optum) or CCN Regions 4-5 (TriWest).

While helping us to protect Veterans from the flu, please help us remind Veterans that they can also receive a COVID-19 vaccine or booster at the same time.

Support and resources

• Billing Information Card
• Flu Shots – Billing
• Flu Shots – Community Care
• Retail pharmacies, urgent care providers: How to provide flu shots to eligible Veterans this flu season
• Community providers: Please tell Veterans about easy, no cost flu shot options through VA
• Influenza (Flu) – VA National Center for Health Promotion and Disease Prevention
• Influenza (Flu) – Centers for Disease Control and Prevention (CDC)