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.
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 a call.
View the listing of preventive services covered under the Affordable Care Act for children and adults.
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 with your health plan ahead of time).
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 old are eligible for VFC vaccines if they are Medicaid-eligible, American Indian, Alaska Native, or have no health insurance.
Also, consult our list of State Immunization Programs.
Adults without health insurance may get COVID-19 vaccines for free through federally qualified healthcare centers, clinics, and pharmacies participating in CDC’s Bridge Access Program. Visit Vaccines.gov to find providers participating in this program.
If you need other vaccines and do not currently have health insurance, visit www.HealthCare.gov to learn more about affordable healthcare options.
If you are 65 years or older and a Medicare beneficiary, Medicare Part D will pay all of the cost of most vaccines recommended by CDC for you, based on your age or disease risk, including vaccines needed for travel.
Medicare Part B covers all of the costs of some vaccines: influenza, pneumococcal, COVID-19, hepatitis B vaccinations for people at increased risk, and vaccines needed after exposure, such as tetanus vaccination after a wound.
To learn more about how adults can access affordable vaccines, visit CDC’s How to Pay for Vaccines.
Beginning October 1, 2023, most adults with coverage from Medicaid and CHIP will be guaranteed coverage of all vaccines recommended by the CDC’s Advisory Committee on Immunization Practice at no cost to them. Check with your state’s Medicaid program or your healthcare provider for details.
For more complete details, contact the manufacturer listed below.
GlaxoSmithKline GSK for You
Provides GSK vaccines to eligible low-income adults who do not have third-party coverage for vaccines. For more information, call 888-825-5249 or visit GSK for You.
Vaccines: Shingrix (RZV)
Merck Patient Support Programs
Intended for uninsured adults 19 years and older. For more information, call 800-727-5400 or visit MerckHelps.com.
Vaccines: Gardasil 9 (HPV9), Recombivax HB (hepB), Vaqta (hepA), MMR ll (MMR), Pneumovax 23 (PPSV23), Varivax (Var), Zostavax (ZVL)
PhRMA Medicine Assistance Tool
PhRMA’s Medicine Assistance Tool (MAT) is a search engine designed to help patients, caregivers, and healthcare providers learn more about the resources available through the various biopharmaceutical industry programs. For more information, visit MAT, the Medicine Assistance Tool.
Sanofi Patient Assistance Connection
Intended for persons 19 years and older who are uninsured. For more information, call 888-847-4877 or visit the Sanofi Patient Assistance Connection.
Vaccines: Adacel (Tdap), Decavac (Td), Menactra (MCV4), Imovax (Rabies) and Imogam (Rabies Immune Globulin)