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Vaccines for Children: Frequently Asked Questions

Who is eligible to receive VFC vaccine?
Who is considered under-insured?
If a patient has health insurance but has a large deductible, is the patient eligible for VFC vaccine?
If a patient has health insurance but has reached their yearly well-care cap, is the patient eligible for VFC vaccine?
Which vaccines are provided?
Can I charge my patients an administration fee?
How will VFC benefit me as a provider?
How do I enroll in the Kentucky VFC Program?

Who is eligible to receive VFC vaccine?
All children birth through 18 years of age who are enrolled in Medicaid, enrolled in the Kentucky Children’s Health Insurance Program (KCHIP), have no health insurance, are American Indian/Alaskan Native or are under-insured.

Who is considered under-insured?
Children whose health insurance plan does not provide, as a covered medical service, any immunizations or does not cover a specific antigen, such as hepatitis A or meningococcal, or the vaccine benefits are capped at a yearly limit after which there is no vaccine coverage for that year.

If a patient has health insurance but has a large deductible, is the patient eligible for VFC vaccine?
Patients whose insurance policy provides for immunizations as a covered medical service, regardless of deductibles are considered insured. They are not eligible for publicly funded vaccine.

If a patient has health insurance but has reached their yearly well-care cap, is the patient eligible for VFC vaccine?
Patients whose insurance policy provides for immunizations as a covered medical service are considered insured and are not eligible for publicly funded vaccine. However, if the vaccine cost is capped at a yearly or annual limit after which there is no vaccine coverage for that year, they are considered under-insured. The vaccine cap must be completely depleted to be considered as under-insured.

Which vaccines are provided?
The Kentucky VFC Program provides all current immunizations recommended by the Advisory Committee on Immunization Practices. These include: diphtheria, tetanus, pertussis, haemophilus influenzae type b, polio, measles, mumps, rubella, hepatitis A, hepatitis B, varicella, pneumococcal conjugate, influenza, rotavirus, meningococcal and Human Papillomavirus vaccines.

Can I charge my patients an administration fee?
Yes. You may charge an administration fee up to $19.93 per injection. This cap is established for Kentucky by the Centers for Medicare and Medicaid Services. If a patient, parent, or guardian is unable to pay the administration fee, you may not deny them the vaccine. If the patient is on Medicaid or KCHIP you may submit claims for the administration fee to the Kentucky Medicaid Program or the KCHIP program.

How will VFC benefit me as a provider?

  • Free vaccines for eligible patients
  • Keep your patients in their medical home for continuity of care
  • Reduce patient out-of-pocket expense
  • Ensure timely vaccinations
  • No cost to participate
  • Medicaid reimbursement for administration costs
  • Free immunization assessments
  • Free training for staff members
  • Regional immunization representative

How do I enroll in the Kentucky VFC program?
Call your local VFC representative at 859.363.2077 and fill out the Kentucky Provider Enrollment forms.

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