Avalere study suggests Medicare should encourage wider adult vaccination coverage

February 17, 2016

Results of an Avalere Health analysis of barriers to increasing vaccination rates found that only about 12% of enrollees on Medicare Advantage Prescription Drug plans were eligible to receive 10 recommended vaccines with no out-of-pocket costs, an increase over last year, when just 5% could get them without a co-pay. The research found 80% to 90% of MA prescription drug plans had a "fixed-dollar" co-pay for the vaccines, higher than the 47% to 72% among standalone prescription drug plans. "Medicare has an opportunity to encourage broader use of these vaccines through expanded coverage," Avalere president Dan Mendelson said. "Options like including vaccine access in the existing star ratings program may encourage more Medicare insurers to cover vaccines at no cost to the patient."