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Paying For Vaccines
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Vaccine Basics

Paying For Vaccines

Most health insurance plans cover the cost of vaccines, but you may want to check with your insurance provider before going to the doctor.
Free Preventive Care for You and Your Family
The Affordable Care Act – the health insurance reform legislation passed by Congress and signed into law by President Obama in March 2010 – requires new health plans to cover preventive services and eliminates cost sharing (such as co-pays and deductibles for certain services). You may be eligible for preventive services including coverage for vaccines.
Call Your Insurance Company to Check if You’re Covered
Most insurance companies are now required to cover the cost of immunizations and preventive care, but a select number of older and more limited plans don’t yet apply to the new law. The best way to find out if you’re covered is by making the call.
View the listing of preventive services covered under the Affordable Care Act for children and adults.
Make Preventive Care the Only Reason for Your Visit
When you book your appointment and when you check in at the doctor’s office, request that the immunizations or preventive care be billed as the primary reason for your visit. In many cases, healthcare plans will cover the entire cost of the visit (confirm the coverage for the visit with your health plan ahead of time).
Vaccines for Uninsured or Underinsured Children
If you don't have insurance, or if it does not cover vaccines, the Vaccines for Children (VFC) program may be able to help. This program provides vaccines at no cost to doctors who serve eligible children. Children younger than 19 years of age are eligible for VFC vaccines if they are Medicaid-eligible, American Indian or Alaska Native or have no health insurance.
To learn more about the VFC program, visit the VFC program website
Consult this list of VFC Coordinators
Learn more about Medicaid in your state
Vaccines for Uninsured Adults
If you do not currently have health insurance, visit www.HealthCare.gov for more information about finding health insurance or the Affordable Care Act.
Medicare and Vaccines
If you are 65 years or older and a Medicare beneficiary, Medicare will pay for part or all of your influenza (flu) , pneumococcal (pneumonia) and hepatitis B vaccines.
To learn more about the vaccines Medicare covers, visit www.Medicare.gov
Source: U.S. Department of Health and Human Services, www.vaccines.gov
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Manufacturer’s Vaccine Assistance Programs
For more complete details, contact the manufacturer listed below
Sanofi Pasteur - Patient Assistant Program (PAP)
Sanofi Pasteur - Patient Assistant Program (PAP)
Intended for persons 19 years and older who are uninsured
Vaccines: Adacel (Tdap), Decavac (Td), Menactra (MCV4), Imovax (Rabies) Imogam (Rabies Immune Globulin) and Menomune (MPSV4)
For more information, 888-847-4877
Merck - Vaccine Patient Assistance Program
Merck - Vaccine Patient Assistance Program
Intended for uninsured adults 19 years and older
Vaccines: Gardasil (HPV4), MMR, Varivax (Var), Zostavax (Zoster)
For more information, call 800-293-3881 or visit www.merck.com
GlaxoSmithKline (GSK)
GlaxoSmithKline (GSK) - Vaccines Access Program
Provides GSK vaccines to eligible low-income adults who do not have third party coverage for vaccines
Vaccines: Cervarix (HPV2), Twinrix (hepatitis A/hepatitis B), Boostrix (Tdap), Havrix (hepatitis A), and Engerix B (hepatitis B)
For more information, call 877-822-2911 or visit www.gsk-vap.com
Pharmaceutical Research and Manufacturers of America (PhRMA)
Pharmaceutical Research and Manufacturers of America (PhRMA)
Prescription Assistance Program
For more information, call 888-477-2669 or visit www.pparx.org
 
Content reviewed on November 19, 2013
Immunization Action Coalition  •  1573 Selby Avenue, Suite 234  •  Saint Paul, MN 55104
tel 651-647-9009  •  fax 651-647-9131
 
The Immunization Action Coalition (IAC), a non-profit organization, works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public that enhance the delivery of safe and effective immunization services. IAC also facilitates communication about the safety, efficacy, and use of vaccines within the broad immunization community of patients, parents, healthcare organizations, and government health agencies.