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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.


Legal Disclaimers


[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/