Participating and Non-Participating Payers
AVAP is pleased to report that the vast majority of payers with beneficiaries in Alaska are participating in AVAP for 2022.
The following payers are not participating for 2022:
- Medicare
- Medicaid
Adult Eligibility Requirements
Child Eligibility Requirements
Click here to learn more about:
- What is a provider opt-in?
- What is the assessment rate this year?
- How do I determine the total number of uninsured adults?
- How do I opt-in for my uninsured adult patients?
- When and how will I be invoiced?
For questions, please e-mail avap@alaska.gov
Yes. Eligibility status screening is still a federal/state requirement for every visit and has not changed.
- V02 = VFC Medicaid Eligible
- V03 = VFC uninsured
- V04 = VFC American Indian/Alaska Native
- V05 = VFC underinsured (FQHC)
- V07 = State Vaccine (AVAP)
- V01 = Ineligible (Private vaccine)
Since the assessment only covers the cost of the vaccine, providers will bill either the payers or the patients directly for vaccine administration fees, as is their current practice.
No. Providers should not include any code in their billing for the state-supplied vaccines. They should only bill for administrative costs.
Not likely. Because vaccines will be purchased in bulk at discounted rates, providers are expected to pay about the same amounts for adult vaccines by opting into the assessment program. Further, the administrative work associated with AVAP should be less when providers opt in because they do not need to separate public and private vaccines in their vaccine storage unit. The provider’s share of the total assessment is based on their number of uninsured adults.
No. Providers do not need to pay for state-supplied vaccines. Providers can receive state-supplied vaccines at no out of pocket cost for all children vaccines and select vaccines for adults covered by participating payers. The assessment for this vaccine is paid by the assessable entities that provide health care coverage for these patients.
Yes. Nothing in the statute prohibits this. However, regulation 3 AAC 26.110 allows payers to reimburse providers at the state's cost for the vaccine, instead of the provider's private purchased priced. Reimbursement rates will be set by payers, providers will need to negotiate this privately with payers.
Patients whose payers have opted into the program will not be charged for the cost of the vaccine; however, some patients may still be charged an immunization administration fee by their provider.
No. The Alaska Immunization Program selects the vaccine formulary to be used. For a listing of the specific vaccines included in the program, please click here.
No. State funds are not sufficient to cover adults who are uninsured or not covered by an assessed payer. Providers who don’t opt in for uninsured can receive state-supplied vaccine only for covered adults with participating payers, but will need to use privately purchased vaccine for uninsured adults and adults with non-participating payers (e.g. Medicaid, Medicare). A list of non-participating payers is posted here.
No. However, providers are able to voluntarily opt into the assessment to receive vaccines for uninsured adults. Providers pay the assessment rate (published on the Payers page) for their uninsured adult patients. Providers who decide not to opt into the vaccine assessment will continue to privately purchase vaccine from the marketplace for their uncovered clients.
No. Providers must complete the annual Vaccine Distribution Program renewal/enrollment process to receive state-supplied vaccine. Providers will receive all children's vaccine and select adult vaccines from the Alaska Immunization Program directly instead of purchasing them privately. Further details are explained in FAQs below and on the AVAP Provider Summary at www.akvaccine.org on the Providers tab. If you have questions, please contact the Alaska Immunization Program at avap@alaska.gov or 907-269-8000. KidsVax®, the administrator for AVAP, does not collect, store or distribute any vaccines.
Yes. Pharmacists may also enroll in the Vaccine Distribution Program to receive state-supplied vaccine for all children and for adults who are covered by participating payers.
The program is able to buy vaccines at discounted rates off a bulk contract compared to market prices. Providers can then receive state-supplied vaccines for all covered patients and avoid the financial and administrative burdens of purchasing vaccines and maintaining separate vaccine storage and tracking systems.
The program is not funded by taxpayers. The program collects the costs of vaccines and program expenses from insurers, third-party administrators, and other payers who are already obligated to pay health care costs for their beneficiaries. These funds are paid directly to the state so the state can purchase vaccines at federal contract rates. This lowers the cost to insurers of funding immunization services.
No. The program does not set vaccine policy or create vaccine laws. It facilitates the state’s universal purchase of vaccines by collecting assessments from insurers, third-party administrators, and other payers to fund the cost of vaccines.
Yes. Eligibility status screening is still a federal/state requirement for every visit and has not changed.
- V02 = VFC Medicaid Eligible
- V03 = VFC uninsured
- V04 = VFC American Indian/Alaska Native
- V05 = VFC underinsured (FQHC)
- V07 = State Vaccine (AVAP)
- V01 = Ineligible (Private vaccine)
Since the assessment only covers the cost of the vaccine, providers will bill either the payers or the patients directly for vaccine administration fees, as is their current practice.
No. Providers should not include any code in their billing for the state-supplied vaccines. They should only bill for administrative costs.
Not likely. Because vaccines will be purchased in bulk at discounted rates, providers are expected to pay about the same amounts for adult vaccines by opting into the assessment program. Further, the administrative work associated with AVAP should be less when providers opt in because they do not need to separate public and private vaccines in their vaccine storage unit. The provider’s share of the total assessment is based on their number of uninsured adults.
No. Providers do not need to pay for state-supplied vaccines. Providers can receive state-supplied vaccines at no out of pocket cost for all children vaccines and select vaccines for adults covered by participating payers. The assessment for this vaccine is paid by the assessable entities that provide health care coverage for these patients.
Yes. Nothing in the statute prohibits this. However, regulation 3 AAC 26.110 allows payers to reimburse providers at the state's cost for the vaccine, instead of the provider's private purchased priced. Reimbursement rates will be set by payers, providers will need to negotiate this privately with payers.
Patients whose payers have opted into the program will not be charged for the cost of the vaccine; however, some patients may still be charged an immunization administration fee by their provider.
No. The Alaska Immunization Program selects the vaccine formulary to be used. For a listing of the specific vaccines included in the program, please click here.
No. State funds are not sufficient to cover adults who are uninsured or not covered by an assessed payer. Providers who don’t opt in for uninsured can receive state-supplied vaccine only for covered adults with participating payers, but will need to use privately purchased vaccine for uninsured adults and adults with non-participating payers (e.g. Medicaid, Medicare). A list of non-participating payers is posted here.
No. However, providers are able to voluntarily opt into the assessment to receive vaccines for uninsured adults. Providers pay the assessment rate (published on the Payers page) for their uninsured adult patients. Providers who decide not to opt into the vaccine assessment will continue to privately purchase vaccine from the marketplace for their uncovered clients.
No. Providers must complete the annual Vaccine Distribution Program renewal/enrollment process to receive state-supplied vaccine. Providers will receive all children's vaccine and select adult vaccines from the Alaska Immunization Program directly instead of purchasing them privately. Further details are explained in FAQs below and on the AVAP Provider Summary at www.akvaccine.org on the Providers tab. If you have questions, please contact the Alaska Immunization Program at avap@alaska.gov or 907-269-8000. KidsVax®, the administrator for AVAP, does not collect, store or distribute any vaccines.
Yes. Pharmacists may also enroll in the Vaccine Distribution Program to receive state-supplied vaccine for all children and for adults who are covered by participating payers.
The program is able to buy vaccines at discounted rates off a bulk contract compared to market prices. Providers can then receive state-supplied vaccines for all covered patients and avoid the financial and administrative burdens of purchasing vaccines and maintaining separate vaccine storage and tracking systems.
The program is not funded by taxpayers. The program collects the costs of vaccines and program expenses from insurers, third-party administrators, and other payers who are already obligated to pay health care costs for their beneficiaries. These funds are paid directly to the state so the state can purchase vaccines at federal contract rates. This lowers the cost to insurers of funding immunization services.
No. The program does not set vaccine policy or create vaccine laws. It facilitates the state’s universal purchase of vaccines by collecting assessments from insurers, third-party administrators, and other payers to fund the cost of vaccines.