• Billing & Reimbursement

A child is covered by health insurance which covers all routine childhood vaccines, but the parent has not met the deductible for the year, is the child eligible for VFC vaccine?

Because of the Affordable Care Act (ACA), all ACA-compliant commercial insurance plans must cover all vaccines included in the recommended immunization schedule for children and adults with no deductible or copay requirement; this includes vaccines on the schedule that are not routine, but are recommended following shared clinical decision-making (such as meningococcal B vaccine for healthy people age 16 through 23). A child who has a form of health insurance that is not ACA-compliant (may be referred to as a grandfathered plan) but which covers the cost of vaccinations as a benefit is not eligible for VFC vaccines, even if the plan requires a copay or requires that they meet a deductible for the year.

Last reviewed: February 14, 2025

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