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Vaccines for Children Eligibility Requirements


Children from birth through 18 years of age who meet at least one of the following criteria are eligible to receive Vaccines for Children (VFC) vaccines:
 

  • Medicaid eligible: A child who is eligible for the Medicaid program. (For the purposes of the VFC program, the terms "Medicaid-eligible" and "Medicaid-enrolled" are equivalent and refer to children who have health insurance covered by a state Medicaid program)
  • Uninsured: A child who has no health insurance coverage
  • American Indian or Alaskan Native
  • Underinsured: A child who has commercial (private) health insurance but the coverage does not include vaccines, a child whose insurance covers only selected vaccines (VFC-eligible for non-covered vaccines only), or a child whose insurance caps vaccine coverage at a certain amount. Once that coverage amount is reached, the child is categorized as underinsured.

Children whose health insurance covers the cost of vaccinations are not eligible for VFC vaccines, even when a claim for the cost of the vaccine and its administration would be denied for payment by the insurance carrier because the plan's deductible had not been met.

While the vaccines are provided at no charge because they have already been paid for with federal tax dollars, doctors and clinics may charge an administration fee to help pay for their costs of doing business.

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