Does Health Insurance Cover Immunizations?

Health insurance provides payment for medical services, including preventive services such as immunizations, in exchange for a monthly premium. The laws regulating health insurance dictate how much coverage must be provided and to whom the benefits must be given. While you can find health insurance through a number of providers -- both private and government based -- you may have access to low-cost or free immunizations if you lack health coverage.

Affordable Care Act

• The Affordable Care Act of 2010 outlines guidelines for health insurance providers concerning routine vaccinations and childhood immunizations. Under the law, all health insurance plans must provide free coverage for this preventive care. Health insurance policy-holders cannot be charged a policy premium for this benefit, and cannot waive this coverage in exchange for a discount on plan premiums. Additionally, the policy-holder cannot accrue any out-of-pocket expenses for immunizations.

Finding Health Insurance

• There are three main sources of health insurance providers from which uninsured people can choose a plan. Government plans are available to certain low-income and disabled persons. CHIP, or children's Medicaid, provides complete health insurance coverage, including immunizations, to children at free or reduced rates. Eligibility and premiums are determined by the income level of the child's guardian. Employers are also major providers of health insurance. In addition to paying toward employee health premiums, some employers will also pay part or all of additional family member premiums. If you have access to neither government nor employer-based insurance, the private market has several options, all of which cover routine vaccinations. Furthermore, under the Affordable Care Act, children cannot be denied health care coverage by an insurance company.

No Health Insurance

• Parents of children who have no health insurance have access to free vaccinations through the federal Vaccines for Children program. All immunizations recommended in the childhood vaccination schedules are included in the program. The immunizations must be administered by an enrolled VCF program provider. There are more than 44,000 providers throughout the United States, and they include pediatricians, general health care providers, health clinics, hospitals and schools.

Other Preventive Care

• In addition to routine immunizations, health insurance plans are required to provide other routine health services free of charge. The Affordable Care Act mandates that all insurance plans cover regular health screenings, such as blood pressure checks, diabetes testing and cholesterol screenings at no cost to the patient. Additionally, all health insurance plans must provide other recommended preventive care such as cancer screenings and regular well-child check-ups with no out-of-pocket costs to the policy-holder.