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County can’t immunize kids with insurance

FORT WAYNE – Beginning July 1, county health departments will not be allowed to provide low-cost immunizations to children whose families have health insurance.

Indiana State Department of Health officials hope the new policy will reserve vaccines for families with the most need.

Families who could see an immediate effect are the underinsured and those who are insured but have high deductibles.

The Allen County Health Department gave 14,471 immunizations last year to 7,020 children. Of those, about 60 percent qualified for Medicaid, 20 percent were uninsured and 20 percent had some kind of insurance, said John Silcox, spokesman for the Allen County Health Department.

While the uninsured and those on Medicaid automatically qualify for the free or low-cost federal Vaccinations for Children, or VFC program, those with insurance will be referred to their family doctors. If their physicians don’t carry the vaccines, families will be able to obtain the immunizations from the health department at cost, Silcox said.

While a typical pre-kindergarten visit to the doctor for immunizations can cost more than $500, the health department charges $25 for a tetanus shot and $60 for an MMR (measles, mumps and rubella) vaccine, Silcox said.

In a May 18 letter issued to Indiana health care providers, State Health Commissioner Gregory Larkin asked physicians not to refer patients to county health clinics for immunizations.

“This policy will change the way we collect information from our clients,” Silcox said.

The department is revamping its application form to include questions about insurance coverage, he said.

Another county health program that may be affected is the “strike team” – a unit of medical professionals sent out to immunize a large group of people at one specific site.

Last year, the health department sent teams to three schools to provide mandatory teen vaccines and sent teams to immunize the residents of three group homes.

This new policy “very well could impact what we can do in situations like that,” Silcox said.

The department may have to gather insurance information on the consent forms and, as a result, some may not be eligible for the immunizations, Silcox said.

Kelly Zachrich, executive director of the Super Shot clinic program, said she understands the reasoning behind the policy.

“There are just so many dollars for the VFC program, and they are trying to serve those who need it most,” Zachrich said.

But, she added, it might be tough on those families who are underinsured and those with high deductibles.

In 2009, 12,243 children received more than 41,000 immunizations through the 29 Super Shot clinics offered throughout Allen County.

Parents fill out a short application, but Zachrich said the agency is not policed.

The form asks for basic information and whether applicants are eligible for Medicaid or Hoosier Healthwise, are uninsured or are underinsured.

There is some concern that a few insured families will not be able to get immunizations through their primary care provider, Zachrich said, because about 20 percent of local physicians no longer carry vaccines.

Journal Gazette

Written by lordsinsurancelog

June 9, 2011 at 9:58 pm

Posted in Insurance News