COVID Vaccine from a Pharmacy

COVID Vaccine Shots can either be billed to your Medical Plan or MedOne your Prescription (Rx) Provider.

If you choose to get a COVID Vaccine shot from a pharmacy and they advise you that they will not electronically file a claim with your medical plan and/or MedOne your prescription (Rx) provider, then you will need to complete a paper claim form and mail it to the appropriate BCBS plan (Iowa – Wellmark; Illinois BCBSIL).  We have provided the direct links below to print out the paper claims as well as the mailing addresses.  If you have any questions please reach out to the Benefits Office at (309) 764-8080.

If you go to an Illinois pharmacy then please use the Blue Cross Blue Shield of IL info below:

Blue Cross Blue Shield of IL

P.O. Box 805107

Chicago, Illinois 60680-4112

https://www.bcbsil.com/PDF/forms/medical-claim-il.pdf

 

If you go to an Iowa Pharmacy then please use the Wellmark Blue Cross and Blue Shield info below:

Wellmark Blue Cross and Blue Shield

Mail Station 1E238

PO Box 9291

Des Moines, IA 50306-9291

https://www.wellmark.com/-/media/sites/public/files/forms/shared/c-2318978_membersubmittedclaimform.pdf