Vaccines save lives, but vaccines can only work if they are administered! One barrier that might limit vaccine uptake is cost. It is important for MIHP providers to understand the numerous routes on “how to pay” for vaccines, to ensure all families have the financial support they need to vaccinate. Below is information about the different ways to pay for vaccines.
Most insurance plans are required to cover recommended vaccines without charge (including copay or coinsurance) when provided by an in-network provider. This is even true for families that have not met a yearly deductible. Under the Affordable Care Act, insurance plans that cover children now allow parents to add or keep adult children on their health insurance policy until they turn 26 years old.175
MIHP providers should help their family check with their insurance provider for coverage details.
Military insurance (TRICARE) covers all of the recommended vaccines for people currently serving in the military and their dependents (family members they support). Depending on the plan there may be a copay or a fee for getting vaccinated.176
MIHP providers should link military families to TRICARE coverage for vaccines webpage for more information.
Medicare Part B covers many vaccines at little or no cost. The costs may vary based on individual Medicare coverage, the vaccine, and whether the provider administering the vaccine accepts Medicare.177
MIHP providers should link Medicare families to medicare.gov for more information.
Medicaid covers all of the recommended vaccines for children and some vaccines for adults.178
MIHP providers should link Medicaid families to medicaid.gov for more information.
If the MIHP family does not currently have health insurance, the MIHP provider should help in assisting to get the family established with a health insurance plan.
To learn more about affordable health coverage options for MIHP families, please visit HealthCare.gov and/or Health Insurance Marketplace.179
If the family does not have any health insurance coverage — or their plan’s out-of-pocket costs for vaccines aren’t affordable — they can still get vaccinated. There are ways to get vaccines for children and adults at a lower cost or for free. Here are some helpful resources:
The Vaccines for Children (VFC) Program
The VFC program is a federally funded program that provides vaccines at no cost to children whose parents or guardians may not be able to afford the vaccines. This helps ensure that all children have a better chance of getting their recommended vaccinations on schedule. Vaccines available through the VFC Program are those recommended by the Advisory Committee on Immunization Practices (ACIP).180
If the MIHP family falls into this category, the MIHP provider is encouraged to assist the family to learn more about the Vaccines for Children program.
Local Health Centers
Federally qualified health centers (FQHCs) provide preventive services and wellness care, including vaccines — and may offer sliding fees based on the family’s income. Click the link to find a health care center near the MIHP family.
Health Departments
Local health departments should have resources for MIHP families to share where to go for free and low-cost vaccines near them.
To find a list of the local health departments in the state of Michigan, go to the Michigan Directory of Local Health Departments.181
