Screen for Eligibility
Eligibility screening must be conducted prior to the administration of any 317-funded vaccines including Vaccines for Adults (VFA) or Local Health Department (LHD) 317. Eligibility is self-reported by the patient and verification of eligibility can be obtained verbally from the patient.
Eligible for VFA or LHD 317 vaccines if at least 19 years of age and
- Has no insurance, or
- Is underinsured: health insurance doesn’t cover vaccines; doesn’t cover all ACIP-recommended vaccines; covers vaccines but with a fixed dollar limit; does not provide first-dollar coverage (i.e., copay, co-insurance or deductible is required).
Eligible for certain VFA or LHD 317 vaccines if at least 19 years of age and
- Has Medicare Part B but not Part D, patient is eligible for:
- Hep A
- HPV
- MenACWY, MMR, Polio (IPV)
- RSV, Tdap
- Varicella and Zoster
- Has Medicare Part D but not Part B, patient is eligible for:
- COVID-19, Hep B, PCV20/PCV21
Document Patient’s Eligibility
There are three important elements to include when you document a patient’s eligibility:
- Date of screening
- If patient is eligible for VFA or LHD 317 vaccines (Y/N)
- If patient is eligible and at least 19 years of age, document which of the criterion above is met (e.g., “317”)
Use a Compliant Record Keeping System
Providers must document the results of the eligibility screening in the patient’s permanent medical record using
- CAIR and Electronic Health/Medical Record (EHR/EMR) or
Note: if your practice’s EMR/EHR does not capture all the necessary screening elements, they may be documented in the system’s notes section. - 317 Eligibility Screening Record for Adult Patients (PDF)
Note: Maintain patient eligibility screening records for a minimum of 3 years
Communicate the Patient’s Eligibility
All staff should be knowledgeable of eligibility. Ensure practice protocols are in place so vaccinators know when to use 317-funded versus private vaccines.
* The adult person would qualify for 317-funded vaccines if they have any copay, co-insurance, and/or deductible for the cost of the vaccine. This policy does not apply for any co-pay, etc., for administration or office visit fees.