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Safety & Prevention

Vaccines for Children Program: Free Immunizations When Cost is a Barrier

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Vaccines are a safe and highly effective way to prevent common diseases that used to seriously harm or even kill infants, children and adults. When your child has all their recommended vaccines on schedule, that helps to ensure that everyone stays healthy. But what if your family can't afford them?

A federally funded program called Vaccines for Children (VFC) may be able to help. VFC works to make sure all children get the vaccinations they need on time without cost being a barrier.

Why immunizations are important

Without vaccines, your child is at risk of becoming seriously ill or even dying from childhood diseases such as measles and whooping cough. These diseases can easily spread at home, school, work or in public places. When enough of us are vaccinated, we help to protect the entire community. This includes people most at risk for serious illness and those who cannot get a vaccine for health reasons.

How to find out if your child is eligible for the VFC program

Children ages 18 years or younger who meet at least one of these requirements qualify for VFC eligibility:

  • American Indian or Alaskan Native

  • Medicaid-eligible

  • Uninsured

  • Underinsured (Your child has health insurance, but the policy might cover only some or no vaccines or has a fixed dollar limit or payment cap.)

Documenting VFC eligibility

You do not have to show any proof that your child is eligible for free vaccines through the VFC program. But your doctor must ask the following questions and document your answers:

  • Is your child on Medicaid?

  • Does your child have any health insurance coverage? Does the insurance cover vaccines?

  • Is your child of American Indian or Alaskan Native heritage?

This information might already be in your child's medical record. If your child's insurance or Medicaid status changes, you need to inform the doctor's office of those changes.

Which vaccines are covered by the VFC program?

The VFC program covers all recommended immunizations for children from birth through 18 years of age.

Preventable diseases that the VFC program vaccines protect children from include:

  • COVID-19

  • Dengue

  • Diphtheria

  • Haemophilus influenzae type b (Hib)

  • Hepatitis A & hepatitis B

  • Human Papillomavirus (HPV)

  • Influenza (flu)

  • Measles

  • Meningococcal

  • Mumps

  • Pertussis (whooping cough)

  • Pneumococcal

  • Polio

  • Rotavirus

  • Respiratory syncytial virus (RSV)

  • Rubella (German measles)

  • Tetanus (lockjaw)

If your child is behind on their vaccine schedule, the VFC program can help them catch up.

Fees that a VFC Program provider may charge

VFC Program vaccines are free, but the law allows your healthcare provider to charge an administration fee. This fee is like a patient's copay; it helps providers offset their costs of giving the vaccine to your child.

Providers can charge what they believe is fair. This could range from no charge up to the maximum amount allowed by their state. This fee varies from state to state. If you are unable to pay the administration fee, your child's provider must still give your child the appropriate vaccines. Contact your Centers for Medicare and Medicaid Services (CMS) regional Medicaid office if you have questions about the administration fee.

Other fees the healthcare provider can charge

  • Fees for non-vaccine services that occur during the office visit, such as a blood test.

  • An office fee for the visit. This fee is paid by Medicaid if your child is covered. If your child is not covered by Medicaid, you are responsible for making payment arrangements with the healthcare provider.

Be sure to ask your provider when you make the appointment what fees they might charge.

Where to find a VFC provider

More than 37,000 providers nationwide are enrolled in the VFC Program. These include pediatricians, public and private health clinics, hospitals, schools, departments of health, pharmacies, Federally Qualified Health Centers and Rural Health Clinics.

To find a VFC Program provider near you, contact your local or state health department to see if your state has a searchable website for VFC Program providers. You can also call providers in your area and ask if they are enrolled in the VFC Program.

CHIP: One way to make sure your child has health coverage

If your child needs health coverage and does not qualify for Medicaid, they may be eligible for the Children's Health Insurance Program (CHIP).

CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP also covers pregnant women. Each state offers CHIP coverage, but rules for who qualifies are different from state to state.

You can apply any time of year to see if you qualify. If you apply for Medicaid coverage through your state health agency, you will also learn if your child qualifies for CHIP. If they do, you won't have to buy an insurance plan for them. Call 1-800-318-2596, go to www.insurekidsnow.gov or fill out an application through the Health Insurance Marketplace. If you qualify, coverage can start immediately.

More information

Last Updated
9/12/2024
Source
Adapted from HealthyChildren Magazine (American Academy of Pediatrics Copyright © 2024)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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