Health Insurance Plans and Immunization: Assessment of Practices and Policies, 2005–2008

Abstract

OBJECTIVES: The goals were to assess private health insurance plans' policies and practices regarding recommended immunizations in 2008 and to identify trends since the America's Health Insurance Plans (AHIP) 2005 Immunization Assessment. METHODS: In May 2008, AHIP staff members e-mailed a survey containing 46 questions on immunization practices to 101 AHIP member private health insurance plans. Of those, 58 responded (representing 121345521 covered individuals) and 43 declined to participate, yielding a response rate of 57% (compared with 53% in 2005). Data are reported as proportions of enrollees (weighted data) or of responding plans (unweighted data). RESULTS: In 2008, almost all enrollees (99.8%) represented in the survey were in health insurance plans that used Advisory Committee on Immunization Practices (ACIP) recommendations to determine coverage. The vast majority (≥99.0%) of enrollees were in plans covering all ACIP-recommended child and adolescent vaccines in ≥75% of the health insurance product lines offered, and ≥16.5% of enrollees were in plans covering these vaccines in all products. The majority of enrollees (≥83.3%) were in plans covering ACIP-recommended pediatric and adolescent vaccines without cost-sharing. Plans covering 95.5% of enrollees updated benefits to reflect changes in vaccine recommendations within ≤3 months, compared with 60.0% in 2005. In 2008, 96.7% of enrollees were in plans that could reimburse providers for vaccines within 3 months once the vaccines were included in benefit designs, compared with 59.2% in 2005. CONCLUSION: The survey shows widespread private health insurance plan coverage of vaccines, consistent with, or better than, the coverage levels reported in the AHIP 2005 survey.