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Major Changes Coming to 'Vaccines for Children' Program, Effective October 1
Posted on: 9/29/2016


If you treat children, make note of upcoming changes to public insurance coverage for vaccinations.

Effective Oct. 1, 2016:

  • Children who have All Kids (Premium Level 1) insurance1 and Illinois’ Child Health Insurance Program (CHIP)1 coverage will no longer be eligible to receive free vaccines through the federally funded, state administered Vaccines for Children (VFC) program.
  • Only children ages 0 through 18 with “regular” Medicaid2 coverage will be eligible to continue receiving free vaccines through the VFC program.

On or after October 1, physicians should verify a child’s eligibility status through the Illinois Department of Healthcare and Family Services (IHFS) MEDI system or risk non-payment.

For your patients who are no longer automatically eligible for free immunizations, you will need to purchase the vaccines to administer and seek reimbursement from the Illinois Department of Healthcare and Family Services (IHFS) or the appropriate Managed Care Organization (MCO).

If you have questions about the VFC program, contact the Illinois Department of Public Health’s immunization program at 217-786-7500 or by email.

Access a slide deck that IHFS developed about eligibility verification and billing for the VFC program.

Your ISMS Advocacy Team is also available to help you with your questions. Contact the team at 800-782-4767 ext. 1470 or send an email.

1 Referred to as Medicaid Title XXI (21) or "State-Funded"
2 Referred to as Medicaid Title XIX (19)

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