Group State/VFC Vaccine Information

New STATE/VFC Vaccine Program

We are pleased to announce that Christie Pediatric Group will be participating in a new STATE/VFC Vaccines program starting July 1, 2011. These programs will cover vaccines for children that are: participating with Medicaid, not insured, or participating with an insurance plan that has limited coverage. Please take the time to review the guidelines below BEFORE your child’s next appointment for vaccines. Click here for information on confirming what coverage is provided by your insurance. Your vaccine and well child check coverage needs to be confirmed prior to your child's next appointment. 

Medicaid:

    The state will continue to provide full vaccine coverage for all children under Medicaid and the Medicaid HMO plans. Christie Pediatric Group currently participates with Healthy Connections, S.C. Solutions, Blue Choice, and UHC Community Plan, Palmetto Physicians, First Choice/Select Health, and Absolute Total Care.

Not Insured:
    The state will continue to provide most vaccines (not including the administration fee) for all children that are not insured. Administration fees are $13 per vaccine. The eligibility information for certain vaccines such as influenza, HPV, etc varies seasonally. Please ask at time of scheduling to know if we are able to provide the vaccine or not.

Limited Coverage:
    The state will provide vaccines (not including the administration fee) for children that are covered under a private insurance plan, but there is limited coverage with vaccines. Administration fees are $13 per vaccine. The eligibility information for certain vaccines such as influenza, HPV, etc varies seasonally. Please ask at time of scheduling to know if we are able to provide the vaccine or not.

Under the new vaccine program starting July 1, 2011 parents/guardians MUST provide documentation stating their eligibility for the State Vaccine Program.
One of four qualifications must be met to be considered eligible:
     1) Insured but coverage does not include vaccines (Underinsured)
     2) Insured but coverage only for select vaccines (eligible for STATE
         vaccine for non-covered vaccines only) (Underinsured)
     3) Insured but coverage capped at certain amount and cap has
         been exceeded (Underinsured)
     4) Health insurance deductible $2,000 or greater (Eligible for STATE
         vaccine only if the deductible has not been met and the family
         cannot afford to pay for vaccine) (Insured Hardship)

Documentation MUST be provided:

    STATE vaccines can only be administered after the doctor has reviewed documentation provided by the parents/guardians stating their eligibility. If documentation is not presented at the time of the visit, there is a possibility that vaccines will have to be scheduled to a later date.
Examples of Documentation for eligibility include:
    - Copy of contract with insurance.
    - Copy of an EOB stating how much their deductible is and how much 
       has been met.
    - Copy of statement off of their insurance website with current information.

Please thoroughly understand what your health insurance provider covers with regards to vaccination and “Well Child Check” visits. Not all insurance providers are the same, and many have limitations or no coverage whatsoever for vaccinations and/or routine well child checks. If you are not certain as to what is or is not covered, you will need to take the time now to call your insurance provider’s customer service number to verify. Vaccinations given at well child checks can be quite costly. If your child is eligible for STATE vaccines, we must know before vaccines are administered. Once private vaccines are given, STATE vaccines cannot be substituted or billed. If your claim is rejected by your insurance, there is no recourse for you but to pay the balance. For a full list of prices, vaccines, and codes billed out for your child’s well child check please click here.


Private Vaccines
    Private Vaccines are the vaccines covered through insurance. These vaccines are purchased by the office and not provided by the state like STATE/VFC Vaccines. All vaccines are manufactured by the same companies and do not differ in quality. Any child that is not eligible for STATE Vaccines, would receive Private Vaccines. Please see the eligibility requirements for STATE Vaccines above for details. If you incorrectly state that your insurance covers your vaccines (and they do not), you would be responsible for the full price of the vaccines. Please confirm your vaccines and well child check coverage prior to your visit. For a full price breakdown, please refer to this page.