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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
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TABLE 3-5
Federal Immunization Coverage Policies for Children Under Medicaid, Vaccines for Children (VFC), and State Children's Health Insurance Programs (SCHIP)
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| Program |
Eligibilitya |
Federal Financing |
| Medicaid |
Children up to age 6: 133% FPLb |
5078% |
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Children aged 618: 100% FPL (through age 21 in the EPSDTc program) |
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State option to cover additional children up to state-defined eligibility levels |
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| VFC |
Children aged 0-18 who are: |
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Medicaid-eligible |
100% |
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Uninsured |
100% |
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Native American /Alaska Native |
100% |
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Underinsured |
Only if vaccinated at FQHCsd |
| SCHIP (Medicaid) |
State sets level using Medicaid coverage flexibility |
Enhanced FFPe (6585%) |
| SCHIP (freestanding) |
Children with incomes above Medicaid but < 50% over Medicaid eligibility levels who are uninsured and ineligible for Medicaid |
Enhanced FFP (6585%) |
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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.
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