Preventive Vaccines (Immunizations) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers preventive vaccines only when FDA‑approved, explicitly recommended for routine use by ACIP using non‑permissive language, and listed on the applicable ACIP immunization schedule; therapeutic vaccines, most travel vaccines, and any vaccines excluded by the member’s benefit plan are not covered under this preventive policy (UHC may apply preventive benefits to FDA‑approved new vaccines during declared public‑health emergencies). Coverage is subject to member‑specific plan terms (non‑grandfathered plans follow PPACA/HRSA/ACIP no‑cost‑sharing rules when given in‑network) and requires documentation of FDA approval, the explicit ACIP recommendation and schedule listing, and that the vaccine is not excluded by the member’s plan.

"A vaccine (immunization) is considered covered after all of the following conditions are satisfied: The US Food and Drug Administration (FDA) has approved the vaccine (immunization); and The vaccin..."