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New York Health Insurers Must Cover Flu Shots

Ruzanna Harutyunyan's picture

Governor David A. Paterson announced that insurers must cover seasonal flu and novel H1N1 vaccinations for children who are aged 19 and younger and enrolled in comprehensive health plans. The policy is consistent with New York’s preventive and primary care provisions known as the Child Wellness Law, which require insurance coverage for vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP) of the federal Centers for Disease Control and Prevention (CDC).

This year, ACIP has advised that children should receive both the seasonal flu and novel H1N1 vaccines. Therefore, under State law, they must be covered and not subject to co-payment, co-insurance or annual deductible.

This is the latest in a series of actions taken at Governor Paterson’s direction so that New York is prepared for the coming flu season. The State has developed and has begun implementing a comprehensive statewide plan to minimize the effects of the virus. On August 31, the Governor launched the statewide tour of the Novel H1N1 Influenza Town Hall Meetings to brief local officials and the public on the State’s plan for the expected resurgence of the novel H1N1 virus.

“As we prepare for the upcoming flu season and the expected resurgence of the novel H1N1 virus, we are working to ensure that New York’s families have access to the resources they need to keep their children healthy,” Governor Paterson said. “The State’s Child Wellness Law requires that all well-child office visits and necessary immunizations be covered by insurers. We want parents to know this flu season, preventive care is available and your insurance company will cover it. In addition, no child who lacks health insurance will be denied access to the vaccine due to inability to pay. Uninsured children will get access to free vaccines through the Vaccines for Children program and local health department flu vaccine clinics.”

Acting New York State Insurance Superintendent James Wrynn said: “The protections provided under the Child Wellness Law are particularly important this season as our children are uniquely vulnerable to this new virus. Governor Paterson has stressed the importance of child health care, and the Insurance Department will continue to do all it can to protect New York’s children.”

Commissioner of the New York State Department of Health, Richard F. Daines, M.D., said: “Governor Paterson’s action today ensures that all children in New York State will have access to the seasonal flu vaccine now and the novel H1N1 flu vaccine when it becomes available. We also thank the federal government for providing novel H1N1 vaccines and supplies to states at no cost.”

New York State and the New York City Department of Health and Mental Hygiene expect to receive batches of the novel H1N1 vaccine from the federal government between late September and mid-October. The vaccine will be distributed to medical providers, including pediatricians, who sign up to receive it.

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The CDC determined priority groups to receive the novel H1N1 influenza vaccine based on experience demonstrating these are the groups most likely to develop serious illness and complications. Among those in the priority groups are pregnant women, children and young adults from 6 months old to 24 years old, and people aged 25 to 64 years old with underlying medical conditions. The individuals in these prioritized groups are strongly encouraged to get the novel H1N1 influenza vaccine when it becomes available. Individuals at risk for complications, particularly those with underlying medical conditions or those who are pregnant, who experience flu-like symptoms at any time should contact their health care provider immediately for treatment.

Novel H1N1 influenza is already circulating throughout the State. In the southern states where school resumed in the past week or two, as well as in colleges and universities, the resurgence of novel H1N1 has been significant. For most individuals, symptoms of novel H1N1 influenza have been mild, however, severe illness and deaths accompanied this strain of flu in the spring and the same should be expected this fall.

“It is my intent to keep New Yorkers as informed as possible about novel H1N1 influenza in New York State. Therefore, in the future, we will provide novel H1N1 influenza updates weekly and as new information about the virus becomes available,” Governor Paterson added. “I want to emphasize that New Yorkers should continue to adhere to the precautionary measures that have been recommended since novel H1N1 influenza was first identified in New York in April. These simple measures include:

o Washing hands often with soap and warm water. Alcohol-based hand cleansers are also effective;

o Avoiding close contact with people who are ill;

o Staying home from work or school if sick;

o Using tissues when coughing or sneezing, or sneezing into your sleeve, not your hands; and

o Keeping hands away from the eyes, nose or mouth.