RSV vaccine is now available for adults 60 years and older

December 11, 2023

senior woman smiling after receiving a vaccination from a nurse

The respiratory syncytial virus (RSV) is a common respiratory virus. Although it usually causes only mild, cold-like symptoms, RSV can be serious. Older adults are more likely to develop severe RSV and need hospitalization.

There are two RSV vaccines licensed by the FDA for use in adults 60 years of age or older in the U.S. If you’re 60 or older, your health care provider might recommend an RSV vaccination for you, especially if you have a weakened immune system, a chronic medical condition or if you live in a nursing home. If any of these apply to you, you might be at higher risk of severe RSV disease. The federal Centers for Disease Control and Prevention recommend a single dose of the RSV vaccine with no maximum age for getting the vaccine. Talk to your healthcare provider to see if the RSV vaccination is right for you.

Is the RSV vaccine covered by my health insurance?

Plans for participants not in Medicare
Your plan	Medical plan	Prescription drug plan	Need help finding a provider/pharmacy?
HealthSelect of Texas^® HealthSelect^SM Out-of-State HealthSelect Secondary participants	Covered at 100% from an in-network provider	Covered at 100% from an in-network provider; bypasses deductible	Medical plan: Blue Cross and Blue Shield of Texas: Call a Personal Health Assistant toll-free at (800) 252-8039 (TTY: 711), Mon. – Fri., 7 a.m. – 7 p.m.; Sat., 7 a. m. – 3 p.m. CT. Prescription plan: OptumRx: Call toll-free at (855) 828-9834 (TTY: 711), anytime until Dec. 31. Express Scripts (non-Medicare): Beginning Jan. 1, call toll-free at (800) 935-7189 (TTY: 711), anytime.
Consumer Directed HealthSelect^SM participants	Covered at 100% from an in-network provider	Covered at 100% from an in-network provider; bypasses deductible

Plans for participants enrolled in Medicare
HealthSelect^SM Secondary participants with Medicare	Not covered	Covered at 100% from an in-network provider; bypasses deductible	UnitedHealthcare: Call toll-free at (866) 868-0609 (TTY: 711); 7 a.m. – 7 p.m. CT, Mon. - Fri.; 7 a.m. – 3 p.m. CT, Sat. until Dec. 31. Express Scripts Medicare (PDP): Beginning Jan. 1, call toll-free at (866) 264-4676 (TTY: 711), anytime.
HealthSelect Medicare Advantage^SM participants	Not covered	Covered at 100% at an in-network provider; bypasses deductible

Plans for participants enrolled in Medicare

Your plan

Medical plan

Prescription drug plan

Need help finding a pharmacy?

HealthSelect^SM Secondary participants with Medicare

Not covered

Covered at 100% from an in-network provider;
bypasses deductible

UnitedHealthcare: Call toll-free at (866) 868-0609 (TTY: 711); 7 a.m. – 7 p.m. CT, Mon. - Fri.; 7 a.m. – 3 p.m. CT, Sat. until Dec. 31.

Express Scripts Medicare (PDP):
Beginning Jan. 1, call toll-free at (866) 264-4676 (TTY: 711), anytime.

HealthSelect Medicare Advantage^SM participants

Not covered

Covered at 100% at an in-network provider;
bypasses deductible

Need help finding a provider/pharmacy?

Blue Cross and Blue Shield of Texas: Call a Personal Health Assistant toll-free at (800) 252-8039 (TTY: 711), Monday – Friday, 7 a.m. – 7 p.m.; Saturday, 7 a. m. – 3 p.m. CT.
OptumRx: Call toll-free at (855) 828-9834 (TTY: 711), anytime until Dec. 31.
Express Scripts (non-Medicare): Beginning Jan. 1, call toll-free at (800) 935-7189 (TTY: 711), anytime.
UnitedHealthcare: Call toll-free at (866) 868-0609 (TTY: 711); 7 a.m. – 7 p.m. CT, Monday - Friday; 7 a.m. – 3 p.m. CT, Saturday until Dec. 31.
Express Scripts Medicare (PDP): Beginning Jan. 1, call toll-free at (866) 264-4676 (TTY: 711), anytime.

If you visit an out-of-network provider, out-of-network benefits will apply. (Please note: Some drugs obtained through BCBSTX may require prior authorization.)

This article was updated Jan. 29, 2024 to reflect changes in Consumer Directed HealthSelect coverage and to provide more clarity on other coverage.