Choice Stories

April 22, 2022

How Employee Health Benefits Help Cover Vaccine Costs

The Centers for Disease Control and Prevention (CDC) routinely reminds Americans – through print, radio, television, and other means – that vaccines can greatly reduce or eliminate the risk of infectious diseases.

Beyond the COVID-19 vaccine, which has been spotlighted for the past 15 months, pharmaceutical companies promote other vaccines on a regular basis. Among them are Hepatitis, Human Papillomavirus, Influenza, and Shingles.

As part of the Affordable Care Act (ACA), all ACA-compliant plans must include coverage for certain vaccines without a copayment or coinsurance when provided by an in-network health care provider. This is even true for patients who have not yet met their annual plan deductible.

What Vaccines Does Health Insurance Cover?

While dosage and availability vary by patient age and health conditions, most health plans include insurance coverage for the following vaccinations:

  • Diphtheria
  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster (Shingles)
  • Human Papillomavirus (HPV)
  • Influenza (Flu)
  • Measles, Mumps, and Rubella (MMR)
  • Meningococcal (MenB)
  • Pneumococcal
  • Pertussis (Whooping Cough)
  • Tetanus (Lockjaw)
  • Varicella (Chickenpox)

The top 10 causes of death in the United States – all exceeding 50,000 lives – are due to the following health conditions:

  • Heart disease (nearly 700,000 annually)
  • Cancer (602,000+)
  • COVID-19 (350,000+)
  • Accidents/unintentional injuries (200,000+)
  • Stroke/cerebrovascular diseases 160,000+)
  • Chronic lower respiratory disease (150,000+)
  • Alzheimer’s disease 134,000+)
  • Diabetes (102,000+)
  • Influenza and Pneumonia (50,000+)
  • Nephritis, Nephrotic Syndrome, and Nephrosis (52,500+)

Health plans participating in the CaliforniaChoice private health insurance exchange offer vaccines through physicians’ offices as well as participating retail pharmacies. For more vaccine information, refer to these web pages:

Anthem Blue Cross

COVID-19 Resource Center

General Vaccine Information

Cigna + Oscar

COVID-19 Resource Center

Frequently Asked Questions

Kaiser Permanente

Your Guide to COVID-19

Vaccine Safety

Health Net

COVID-19 Resource Center

Preventive Health Guidelines

Sharp Health Plan

COVID-19 Resource Center

Keeping Up With Vaccinations

Sutter Health Plus

COVID-19 Coverage, Cost, and Access to Care

What Is Preventive Care?

UnitedHealthcare

COVID-19 Resource Center

What’s a Vaccine?

Western Health Advantage

Coronavirus (COVID-19) Disease

Search Results for “Vaccine”

To learn more about preventive care services and other benefits and services offered to members through CaliforniaChoice, talk with your employee benefits broker. If you do not already have a broker, you can search for one on the MyCalChoice website.

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