Insurance Commissioner: Vaccine Insurance Coverage in Delaware

In the wake of federal changes, Insurance Commissioner Trinidad Navarro and the Delaware Department of Insurance wish to inform residents about carrier's intentions regarding insurance coverage for immunizations.

"Vaccines save lives," said Insurance Commissioner Trinidad Navarro. "They save money, preventing costly diseases and conditions, keeping insurance and care affordable. They save health care capacity, a critical resource to retain as we face provider shortages. But again, and most importantly: they save lives."

"Residents are reaching out, concerned that they will lose coverage for and access to the immunizations we rely on to keep our communities healthy. I am proud to share that several of our commercial carriers have committed to continuing to provide their current level of vaccine coverage to policyholders, and we continue to work to ensure consumers have access to information from all insurers operating in Delaware."

AHIP, America's Health Insurance Plans, a national association, stated "As we navigate an evolving health care landscape, maintaining robust immunization coverage continues to be a top priority for protecting both individual and community health. We are committed to ongoing coverage of vaccines to ensure access and affordability for this respiratory virus season. We encourage all Delaware residents to talk to their health care provider about vaccines."

Aetna CVS Health said "From an Aetna perspective, we continue to provide coverage for approved vaccines, including COVID-19, in compliance with applicable state and federal cost-sharing requirements. All members of insured plans voluntarily choosing to vaccinate against COVID-19 may do so with no cost sharing."

"In addition to offering fully insured plans, Aetna also administers benefits on behalf of thousands of self-funded employers. As with all coverage decisions, self-funded employers determine their own insurance coverage as allowed under various federal and state laws."

AmeriHealth Caritas said "AmeriHealth Caritas supports our members who choose to get vaccinated by providing vaccine coverage. This coverage is in line with the preventive care service requirements in the Affordable Care Act (ACA). We encourage all Delaware residents to talk to their healthcare providers regarding vaccinations."

Delaware First Health, also known as Centene, Celtic, and Ambetter Health of Delaware, reported that "We're committed to providing coverage for evidence-based treatments, including vaccines. Ambetter Health of Delaware continues to cover COVID-19 and other vaccinations in alignment with public health guidance, and we encourage members to consult with their physician about all care needs, including vaccinations."

Highmark shared "Highmark has not changed our vaccine coverage or medical policies on vaccinations. Members should be always consulting with their physician about personal health care needs."

UnitedHealthcare stated "There have been no immediate changes to vaccine coverage for our commercial members. We continue to monitor and evaluate the latest guidance."

Cigna did not share commitments at the time of this advisory but is a member of AHIP. This web posting will be updated if shared at a later date, or if carriers modify their coverage determinations.

The Department of Insurance will continue to work with state partners to ensure that vaccine coverages are not diminished. In their commitments to coverage, insurers must provide adequate access to the immunizations offered. Sites of care may shift as health providers and pharmacies determine their paths forward, but carriers will work to ensure continued access even at different network providers. Should insurers' coverage change, regulatory and/or legislative requirements will be developed.

This consumer advisory does not advise on coverage outside of the commercial market, such as through a self-insured employer, or Medicare Advantage plans, which are not regulated by the Department of Insurance.