Does Health Insurance Pay for Travel Vaccinations?

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You need immunizations to travel internationally, but will your health insurance pay for your travel shots?. Image © Jodi Jacobson/Getty Images

Going on an exotic foreign vacation? Traveling internationally for work? In both instances, your travel could put you at risk for infectious diseases you wouldn’t be exposed to at home.

The good news: we have vaccines to prevent many of these diseases so your travel can be safer. The bad news: these vaccines can sometimes be expensive, and your health insurance might not cover them.

The Affordable Care Act says all routine vaccinations must be covered by health insurance as a preventive health measure without cost-sharing.

However, it doesn’t mandate that non-routine vaccinations must be covered. So, whether your health insurance has to pay for your travel vaccinations depends on which immunizations you need and whether or not those immunizations are on the list of adult vaccines considered routine by the Advisory Committee on Immunization Practices.

Unfortunately, most vaccines recommended for foreign travel aren’t on the list of adult vaccines considered routine by ACIP, so your health plan doesn’t have to pay for most travel vaccines. The exception is Hepatitis A which is on the routine list for some people, and also recommended for travel to many destinations.

Even if one or more of your travel vaccines is on the list of routine adult vaccines, your health insurance won’t have to pay for it if you don’t get it through an in-network provider. Also, grandfathered health plans don’t have to follow the free preventive care rules of the Affordable Care Act, so even routine vaccines might not be covered if you have a grandfathered plan.

However, just because the ACA doesn’t force health insurers to cover travel vaccinations without cost-sharing doesn’t necessarily mean your health plan doesn’t offer some kind of coverage as an extra perk. Some do, although you may have to pay a copayment. The only way to know for sure is to ask your health plan, your workplace benefits department, or read your Summary Plan Description booklet.

Traveling for Business?

If your foreign travel is a requirement of your job, check with your employee health department to see what services they provide for foreign business travel. You may be able to get your required vaccinations through the employee health office.

If employee health can’t help you, you may be successful in requesting your travel vaccinations be covered if your employer’s health plan is self-funded. Don’t assume that, because your health plan sounds like it’s a brand-name insurance company, it’s not a self-funded plan. Many times big-name insurers provide the management and claims processing for large-employer self-funded plans. The only way to know for sure is to ask or to check your plan’s Summary Plan Description.

Since claims for self-funded plans are paid by your company rather than by a health insurer, your company has more freedom to decide to cover a claim that isn’t specifically stated as a benefit. You’ll need to do some legwork and some convincing, but it’s not unreasonable to request that your company pay reasonable costs for vaccines needed to keep you healthy while you’re traveling for work.

Sources:

The Center for Consumer Information & Insurance Oversight,  Affordable Care Act Implementation FAQs - Set 12. Accessed Sept 28, 2014.
Healthcare.Gov Preventive Health Services for Adults. Accessed Sept 28, 2014.

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