TN Vaccines for Children (VFC) Program
What is the history of the Vaccines for Children Program?
The Vaccines for Children (VFC) Program was established by Congress in 1993. The VFC Program is an entitlement program (a right granted by law) for eligible children, age 18 years and younger. VFC helps families of children who may not otherwise have access to vaccines by providing free vaccines to doctors who serve them. VFC is administered at the national level by the CDC, that contracts with vaccine manufacturers to buy vaccines at reduced rates. Tennessee enrolls physicians who serve eligible children and provide routine immunizations. More than 600 private physicians, health department clinics, federally qualified health centers (FQHC) and rural health centers (RHC) participate in VFC in Tennessee.
Which Children are Eligible in Tennessee?
Children from birth through 18 years of age who meet at least one of the following criteria are eligible to receive VFC vaccine:
- TennCare eligible: A child who is eligible for Medicaid or enrolled in the TennCare program
- Uninsured: A child who has no health insurance coverage
- American Indian or Alaska Native: As defined by the Indian Health Care Improvement Act (25 U.S.C. 1603)
- 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 dollar amount. Once that coverage amount is reached, the child is categorized as underinsured. In Tennessee, underinsured children are eligible to receive VFC vaccine only through an FQHC, RHC or local health department.
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.
Do I have to pay anything?
If your child meets one of the VFC eligibility criteria listed above, the vaccine must always be provided free of charge. However, each immunization provider has been granted (by law) the ability to charge what is called an "administrative fee." An administrative fee is similar to a patient's co-pay, in that it helps providers offset their costs of doing business. The amount of the administrative fee cannot exceed $20 per dose in Tennessee, based on a regional scale determined by the federal Centers for Medicare and Medicaid Services (CMS).
These regional administrative charges are maximum fees that providers may ask patients to pay. The provider may ask for less than this amount, if they feel that is fair.
How do I find a VFC Provider?
Ask your child’s healthcare provider if they participate in VFC, or contact your local health department.
How does a healthcare provider join VFC?
Healthcare providers interested in joining the VFC Program may contact the Tennessee Immunization Program at (800) 342-1813 for enrollment information.