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Department: Health & Environment
Release Date: Dec 20, 2012
The Larimer County Department of Health wants to inform the public that new federal requirements will mean that, beginning January 1, 2013, the department will no longer be able to use federally-purchased vaccines to immunize most insured children and adults.
“Insured” is defined as anyone with insurance that would generally cover the costs vaccination. Even those with copayments or high deductibles that have not been met are considered “insured” according to these new requirements.
According to Chandra Klein, the Health Department’s Immunization Program Supervisor, funding for the federally-purchased vaccines used by the Health Department is shrinking and must be prioritized for those with the least ability to pay for immunizations. “The new federal requirements are intended to ensure that publicly-funded doses go only to those eligible and most in need,” she said.
Klein added that because the Affordable Care Act (ACA) requires most insurance policies to cover recommended immunizations, the number of uninsured and underinsured should decrease. Certain clients the department has served in the past will be able to get their vaccines at their primary care providers, since immunizations will be covered by insurance. Some who have used the Health Department clinics for convenience or by preference will need to obtain vaccines from their primary care providers, or be referred to pharmacies that provide vaccinations and can bill insurance companies.
The Health Department will continue to provide immunizations using Federally-purchased vaccines for the following persons:
Children on Medicaid.
Children with no health insurance.
Children whose health insurance does not cover vaccines.
Children who are American Indian or Alaskan native- (no matter what insurance coverage they do or do not have)
Adults with no insurance - limited types of vaccines
Adults whose insurance does not cover vaccines - limited types of vaccines.
The department may have limited supplies of vaccine that could be used for adults with insurance, but patients will need to pay full price for the vaccine. They can try to seek reimbursement by submitting their receipt to their insurance on their own.
International travel clients – No changes for travel clinics. Clients will be charged full cost, which must be paid at the time of service.
The Health Department will still be able to use federally-purchased vaccines to respond to outbreaks, regardless of insurance status.
The policy change will impact local public health agencies nationwide that do not have the capacity to bill commercial insurance. While the Larimer County Department of Health and Environment is looking into the feasibility of billing commercial insurance at some time in the future, at this time it is uncertain whether we will be able to do so.
For information on the Larimer County Health Department’s Immunization Clinics, go to www.larimer.org/health or call 498-6700.
For information on preventive health care services covered under the Affordable Care Act, go to pricelessprevention.org