From CSmoot - Minnesota Vaccines for Children (MnVFC) Eligibility Change

Due to cuts in federal funding and increases in the cost of vaccine, the Minnesota Department of Health (MDH) must make eligibility changes to the Minnesota Vaccines for Children (MnVFC) program. Starting July 1, 2012, MDH will no longer be able to provide MnVFC vaccine for underinsured children in private clinics. However, underinsured children will still be able to receive MnVFC vaccine at public clinics (i.e., Federally Qualified Health Centers (FQHC), Rural Health Centers (RHC), local public health (LPH), Indian Health Services (IHS), and tribal clinics).

 

To implement this change in MnVFC eligibility, there will be an adjustment period from April 1, 2012 to June 30, 2012. During this adjustment period, private clinics will make the changes needed to discontinue providing MnVFC vaccine to underinsured children. Clinics may stop providing MnVFC vaccine to underinsured children at any time during the adjustment period.

 

In March, MnVFC clinics will receive more detailed information about this change by mail along with updated MnVFC eligibility screening forms.

 

What is the difference between a private and public clinic?

For the purposes of MnVFC eligibility, a private clinic is any site that is not an FQHC, RHC, LPH, HIS, or tribal clinic.

A public clinic is an FQHC, RHC, LPH, IHS, and tribal clinic. 

• A Federally Qualified Health Center (FQHC) is a health center that is designated by the Bureau of Primary Health Care (BPHC) of the Health Services and Resources Administration (HRSA) to provide health care to a medically underserved population.     
• A Rural Health Center (RHC) is designated by the Centers for Medicare and Medicaid Services (CMS) and is a clinic located in a Health Professional Shortage Area, A medically Underserved Area, or a Governor-Designated Shortage Area.   
• These sites are listed on the MDH website at www.health.state.mn.us/vfc.

 

 Which children will be eligible at public versus private clinics?

	Public clinic	Private clinic
Minnesota Health Care Program (MHCP) eligible	Yes	Yes
Uninsured	Yes	Yes
American Indian/Alaskan Native	Yes	Yes
Underinsured	Yes	No

 

What is the definition of underinsured?  

A child is underinsured if he or she:

• Has health insurance that does not cover one or more vaccines (MnVFC-eligible for non-covered vaccines only).
• Has health insurance that caps vaccine coverage at a certain amount; once that amount is reached, the person is MnVFC-eligible.     
• Has health insurance that does not cover vaccine until the deductible has been paid; once the deductible has been paid, the person is no longer MnVFC-eligible.  

The eligibility criteria only apply to the insurance coverage for cost of vaccine and do not include caps or deductible that would apply to other services like an office visit or administration fee.