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MI DIFS Reminds Consumers That Health Insurance May Cover Life-Saving Vaccines
October 04, 2023
This press release was updated on October 12, 2023 with new information.
FOR IMMEDIATE RELEASE: October 4, 2023
(LANSING, MICH) With the fall and winter respiratory disease season approaching, the Michigan Department of Insurance and Financial Services (DIFS) is reminding Michiganders that the Affordable Care Act (ACA) requires most health plans in Michigan to cover specific vaccines with no out-of-pocket costs. This includes COVID-19, flu, and respiratory syncytial virus (RSV) vaccines for eligible people.
“With the colder weather comes increased risk from viruses like COVID-19, influenza, and RSV, and vaccines to help prevent these diseases are available with no out-of-pocket cost for eligible Michiganders,” said DIFS Director Anita Fox. “DIFS stands ready to assist consumers with any questions or concerns about their health insurance. Our live call center can be reached Monday through Friday, from 8 a.m. to 5 p.m., by calling 877-999-6442.”
Coverage for vaccinations is considered an essential health benefit under the ACA. In most cases, COVID-19 vaccines and flu shots must be covered without out-of-pocket cost by most health plans in Michigan if the vaccination is given by an in-network medical professional. Insurance coverage for an RSV vaccination is required for:
- Adults aged 60 years or older.
- Infants older than 8 months born during or entering their first RSV season.
- Infants and children aged 8-19 months who are at increased risk for severe RSV disease and entering their second RSV season.
- Note: These requirements take effect in summer 2024, though insurers may offer this coverage now. Please contact your insurer with questions about your coverage.
Michiganders covered by government-provided health coverage can receive COVID-19, flu, and RSV vaccines at no cost. According to information published by the Centers for Medicare & Medicaid Services, vaccines are available at no cost to eligible people enrolled in Medicare, Medicaid, and Children's Health Insurance Programs such as Michigan's MIChild program.
Consumers with questions about health insurance coverage for vaccines should contact their insurance company. If they cannot get the information they need or have additional questions, they should contact DIFS for assistance 8 a.m. to 5 p.m. Monday through Friday at 877-999-6442 or Michigan.gov/HealthInsurance.
DIFS is reminding Michiganders that Health Insurance Marketplace open enrollment will begin on November 1, 2023. During this open enrollment period, consumers can change their current plan or enroll in a new plan for coverage beginning January 1, 2024, by visiting the Health Insurance Marketplace or by calling 800-318-2596 (TTY: 1-855-889-4325). Consumers may also qualify for a Special Enrollment Period to obtain health insurance now if they have experienced certain qualifying life changes. Additional information, including links to find free local help from navigators, is available on the DIFS website or by calling DIFS 8 a.m. to 5 p.m. Monday through Friday at 877-999-6442.
The mission of the Michigan Department of Insurance and Financial Services is to ensure access to safe and secure insurance and financial services fundamental for the opportunity, security, and success of Michigan residents, while fostering economic growth and sustainability in both industries. In addition, the Department provides consumer protection, outreach, and financial literacy and education services to Michigan residents. For more information, visit Michigan.gov/DIFS or follow the Department on Facebook, Twitter, or LinkedIn.