VT| The Vermont Department of Financial Regulation‘s Insurance Bulletin 238 (October 2025) directs all Vermont-regulated health plans to cover vaccines recommended by the Vermont Department of Health (VDH) and the federal Advisory Committee on Immunization Practices (ACIP) without cost-sharing or utilization review, provided members meet VDH guidelines. This includes broad coverage for COVID-19, influenza, and RSV vaccines for most age groups, with guidance reflecting current CDC, AAP, ACOG, AAFP, and IDSA recommendations; health plans must clearly communicate access procedures, and third-party administrators of employer plans are encouraged to voluntarily comply with these requirements to protect public health.
Key Points:
- Vermont-regulated health plans are required to cover vaccines—such as those for COVID-19, influenza, and RSV—recommended by VDH and ACIP without cost-sharing or prior utilization review, provided official guidelines are met.
- Plans must communicate clear benefit access instructions to members and are encouraged to ensure at least one FDA-approved vaccine for each VDH guideline item is available on their formulary; TPAs of employer-sponsored plans are urged to align with this directive for public health protection.
