DE| The Delaware Department of Insurance issued Bulletin No. 167 (effective immediately) directing all health insurance carriers doing business in Delaware to cover accelerated MMR vaccination for infants ages 6–11 months in response to a confirmed measles outbreak in Kent County, after reports that some carriers were declining these early doses and pushing families toward public clinics. Citing 18 Del. C. §§ 3363 and 3558 — which mandate no-cost coverage of ACIP-recommended immunizations — the Department expects carriers to treat the outbreak-driven early dose as covered preventive care statewide, with the guidance sunsetting once the Division of Public Health declares the outbreak resolved.
Key Points:
- Related guidance and duration: Medicaid coverage runs separately through DMMA under the federal EPSDT benefit (consult DMMA for program-specific rules); the Department will continue monitoring DPH/CDC guidance and issue updates, with questions directed to compliance@delaware.gov.
- Coverage scope: Early MMR doses for infants 6–11 months must be covered regardless of county of residence (not just Kent County), given measles transmissibility and cross-county travel; the extra dose does not replace the two routine doses required after 12 months.
- No barriers to access: Doses must be reimbursed as medically necessary preventive care with no cost-sharing, no prior authorization, and no administrative hurdles — a provider’s clinical determination alone is sufficient documentation, and carriers should promptly update claims-processing protocols and provider communications.