Revenue Cycle
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Vaccines: Your Best Shot?

by | Oct 31, 2018 | Uncategorized

You might not believe this, but it is estimated that 450 people worldwide die everyday from the measles.  Sounds unrealistic doesn’t it?  Vaccines were thought to have eradicated most preventable diseases we’ve known of since the 1800’s.  However, with a wave of “anti-vaxxers” and other controversial conversations surrounding the topic, many parents are questioning whether they should vaccinate their children or not.  Regardless of which side of the debate you stand on, there is another group of individuals who are still markedly underrepresented.

Today, parents are given the choice to “opt-out” of preventable health care for their children.  However, for some parents it’s not just a complicated ethical or moral decision. We’ve all been faced with the dreaded co-pay at the doctor’s office when we go to get checked out for those “flu-like” symptoms, but for some it runs much deeper than that.  Some parents and children who are underinsured areas cannot afford to get the vaccines they need for school, travel, etc, all because of these two words: cost sharing.

Cost sharing, the share of costs covered by your insurance, entails that your have to pay a portion of the costs for your health care benefits depending on what your out-of-pocket maximum may be, a nightmare for people in states that haven’t  adopted the expansion of Medicaid programs like: Alabama, Florida, Georgia, Kansas, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming, with Utah, Nebraska, and Idaho still considering the expansion.  Many parents and families in these states struggle to gain access to affordable health coverage. If you are a typical family of four, to receive the highest cost sharing reduction, meaning what your provider will cover, you have to have a combined monthly income of $2,092, which for some seems unattainable.

In 2010, when the Affordable Health Care Act (ACA) was enacted under the Obama Administration,  Congress passed annual funding to rally America’s public health underpinning. This included the availability of coverage for Advisory Committee on Immunization Practices (ACIP) required census of immunizations.  The ACA plays a vital role in the lives of children and parents who have high deductibles for the year and may not have the opportunity to receive those vaccines ,without breaking the bank, until the costly out-of-pocket maximum is reached for that plan year.  The ACA has helped millions of people gain access to vaccinations by requiring the implementation of coverage in private health care plans for routine immunizations sanctioned by ACIP, without cost sharing. So, whether you qualify for cost sharing or have plans under Medicaid, get with your health care provider to find out exactly what criteria you need to fall under to be eligible for vaccination coverage with no cost sharing.  

At American Exchange, our licensed agents will be more than happy to help you enroll in the health care plan that is right for you. Open enrollment for 2019 health insurance starts in just a few weeks, running from November 1-December 15, 2018. If you would like to learn more about the options that are available to you, we invite you to contact us at 1-888-995-1674 for a free assessment.

Article contributed by American Exchange Enrollment Specialist Rachel Quinn