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Table 3-5 | Calling the Shots: Immunization Finance Policies and Practices | Committee on Immunization Finance Policies and Practices | Division of Health Care Services and Division of Health Promotion and Disease Prevention | Institute of Medicine

TABLE 3-5
Federal Immunization Coverage Policies for Children Under Medicaid, Vaccines for Children (VFC), and State Children's Health Insurance Programs (SCHIP)

 
Program Eligibilitya Federal Financing
Medicaid Children up to age 6: 133% FPLb 50–78%
  Children aged 6–18: 100% FPL (through age 21 in the EPSDTc program)  
  State option to cover additional children up to state-defined eligibility levels  
VFC Children aged 0-18 who are:
  Medicaid-eligible 100%
  Uninsured 100%
  Native American /Alaska Native 100%
  Underinsured Only if vaccinated at FQHCsd
SCHIP (Medicaid) State sets level using Medicaid coverage flexibility Enhanced FFPe (65–85%)
SCHIP (freestanding) Children with incomes above Medicaid but < 50% over Medicaid eligibility levels who are uninsured and ineligible for Medicaid Enhanced FFP (65–85%)
 

    a The Advisory Committee on Immunization Practices establishes general vaccine schedule recommendations and then prepares a separate resolution for coverage through the VFC Program. CDC publishes the recommendations and negotiates a vaccine contract(s). Funds are awarded to the states, and the vaccine is purchased and supplied by the states to health care providers.

    b Federal poverty level.

    c Early and Periodic Screening, Diagnosis, and Treatment Program.

    d Federally qualified health center.

    e Federal financial participation.

    SOURCE: Health Care Financing Administration, 2000c.