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Past Newsletters
- September 2017
- Sept. 13 MLR Checks Mail
- Sept. 28 Rx Prior Authorization, Medicare Cards
- August 2017
- Aug. 9 Transitional Relief Update
- Aug. 23 Medicare Creditable Coverage Mandate
- July 2017
- July 12 Digital Onboarding
- July 26 PCORI Fee Due July 31
- June 2017
- June 14 MLR Schedule Released
- June 28 Data Assessment Requirement
- May 2017
- May 10 IRS 6055 Collection Data
- May 24 IRS Issues 2018 HSA Amounts
- April 2017
- April 12 New Preventive Measures Announced
- April 26 New Client Tracking Tool Introduced
- March 2017
- March 8 ACA Update for Aggregate Groups
- March 22 July 1 PDL Changes
- February 2017
- January 2017
- Jan. 11 Broker Bonus Announced
- Jan. 25 Court Bans Gender Enforcement
- December 2016
- November 2016
- Nov. 9 IRS Releases New FSA Amounts
- Nov. 23 CMS Ratings Released
- October 2016
- Oct. 14 Section 1557 Update, Reinsurance Notice
- Oct. 26 Reinsurance Quiz
Local and Other News
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UnitedHealthcare adds Shingrix vaccine to preventive benefits beginning April 1
February 10, 2018
On Oct. 20, 2017, the U.S. Food and Drug Administration (FDA) approved the new shingles vaccine, Shingrix®, for the prevention of herpes zoster in adults ages 50 years and older. On Jan. 26, 2018, the Advisory Committee on Immunization Practices (ACIP) recommendations on Shingrix were adopted by the Centers for Disease Control and Prevention (CDC) with its publication in the Morbidity and Mortality Weekly Report (MMWR).
According to the ACIP recommendation, Shingrix is:
- Recommended for healthy adults ages 50 years and older to prevent shingles and related complications;
- Recommended for adults who previously received the Zostavax® shingles vaccine to prevent shingles and related complications; and
- The preferred vaccine for preventing shingles and related complications.
Network coverage at no cost share
For non-grandfathered, fully insured and self-funded customers that follow UnitedHealthcare standard preventive services benefits, Shingrix will be included as a covered benefit beginning April 1, 2018.
Shingrix is paid as preventive under the medical benefit, not the pharmacy benefit.
ACIP has not recommended Shingrix for individuals ages 49 and younger.
Coverage for the Shingrix vaccine at no cost share is available in network through most:
- Physician’s offices.
- Urgent care centers.
- National convenience care clinics*:
- MinuteClinic® located in CVS®, Target® and Longs Drugs
- Walgreens® Healthcare Clinic
- RediClinic® located in Rite Aid® and H-E-B®
- The Little Clinic® located in Kroger®
- Walmart® Care Clinic
- National retail pharmacies* that are contracted to administer the vaccine.
* Eligible members may show their health plan ID cards to receive the Shingrix vaccine on a walk-in basis from these national providers.
Preventive care services CDG code and benefit limits
Shingles Vaccine |
CDG Code Covered |
Benefit Limit |
Description |
Shingrix** |
90750 |
Ages 50 |
Zoster (shingles) vaccine (HZV), recombinant, sub-unit, adjuvanted, for intramuscular use. Requires 2 injections. |
Zostavax |
90736 |
Ages 60 |
Zoster (shingles) vaccine (HZV), live for subcutaneous injection. One injection. |
** Shingrix is FDA approved and recommended by ACIP for use in immunocompetent adults aged 50 and older.
Refer to UnitedHealthcare Preventive Care Services Coverage Determination Guideline for a list of vaccines and supporting information that are covered at no cost share.
Please contact UnitedHealthcare if you have questions.
January 1, 2018 PDL Updates

The following updates will take effect for the OptumRx direct Prescription Drug Lists (PDLs) on January 1, 2018. Learn more
New Sales Automation Management Tool

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