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Are Immunizations Free Under Obamacare?

Are Immunizations Free Under Obamacare?

Posted Apr 24, 2017 by Jenifer Dorsey

 

What Vaccines Are Covered By ACA Health Insurance Plans

Immunization vaccines are considered an important part of preventive healthcare for children and adults.[1]As such, the Affordable Care Act requires private group and individual health insurance plans to include vaccines among covered preventive services—covered preventive services are offered to insured adults and children at no additional cost beyond their monthly plan premium.

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ACA-covered immunization vaccines

The Advisory Committee on Immunization Practices recommended which immunization vaccines for adults and children should be among Obamacare’s covered preventive services.[2] These vaccines include the following and apply to all major medical plans effective on or after Sept. 23, 2010, whether they are purchased in the private market or from a state-based or federally facilitated health insurance exchange:

Adults[3]

  • Diphtheria
  • Hepatitis A
  • Hepatitis B
  • Herpes zoster
  • Human papillomavirus (HPV)
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Mumps
  • Pertussis (whooping cough)
  • Pneumococcal
  • Rubella
  • Tetanus
  • Varicella (chickenpox)

2016 recommended immunizations for adults, by age (ages 19 and older)

Children[4]

  • Diphtheria, tetanus, pertussis (whooping cough)
  • Haemophilus influenzae type B
  • Hepatitis A
  • Hepatitis B
  • Human papillomavirus (PVU)
  • Inactivated poliovirus
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Pneumococcal
  • Rotavirus
  • Varicella (chickenpox)

2016 childhood immunization schedule (birth through 6 years old)

2016 adolescent immunization schedule (7 through 18 years old)

Immunizations covered by Medicare, Medicaid, CHIP

If you and your family members are covered by Medicare, Medicaid, CHIP or other health insurance plans that may or may not qualify as minimum essential coverage under Obamacare, check with your plan to determine immunization benefits.

A note on ACA-covered immunization vaccines schedules, doctor recommendations

Vaccine doses, the recommended age at which they are received and the populations that should receive them may vary. Your healthcare provider will suggest an immunization schedule appropriate for you.

Even with Obamacare’s essential health benefits and covered preventive services, health insurance benefits differ by plan. Always check with your health insurance plan to confirm your current benefits for immunizations and other healthcare. 

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Originally posted September 2, 2015. Last reviewed and updated August 12, 2016.



[1] U.S. Department of Health & Human Services. “The Affordable Care Act and Immunization.” Last updated Jan. 20, 2012. http://www.hhs.gov/healthcare/facts/factsheets/2010/09/The-Affordable-Care-Act-and-Immunization.html

[2] Ibid.

[3] HealthCare.gov. “Preventive Care Benefits for Adults.” Accessed Aug. 8, 2016. https://www.healthcare.gov/preventive-care-adults/

[4] HealthCare.gov. “Preventive Care Benefits for Children.” Accessed Aug. 8, 2016. https://www.healthcare.gov/preventive-care-children/

These products are not qualifying health coverage (“Minimum Essential Coverage”) that satisfies the health coverage requirement of the Affordable Care Act. If you don't have Minimum Essential Coverage, you may owe an additional payment with your taxes. The termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. These products may include a pre-existing condition exclusion provision.

About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries since 1980. The IHC Group owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), and IHC Specialty Benefits, Inc., a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers.

About IHC Specialty Benefits
IHC Specialty Benefits, Inc. (IHC SB) is a technology-driven, full-service marketing and distribution company that focuses on small employer and individual consumer products through general agents, telebrokerage, advisor centers, and private-label arrangements. IHC SB conducts business under the following brands: Healthedeals.com; Health eDeals Advisors; Aspira A Mas; and PetPlace.com. For more information about IHC SB visit http://www.ihcgroup.com/companies.