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Augusta, Maine -

Bureau of Insurance Superintendent Mila Kofman is highlighting steps being taken by the Bureau and Maine insurance companies to facilitate access to the H1N1 vaccine for those individuals who voluntarily choose to be vaccinated. The Bureau of Insurance has been working with insurers and other State agencies on actions that will reduce or eliminate costs for health plan members, while also simplifying and streamlining the process.

Superintendent Kofman explained that Aetna, Anthem, CIGNA, Harvard Pilgrim, and United Health Care are taking important steps to eliminate barriers for their members who choose to be vaccinated as supplies become increasingly available. These companies are waiving copays, coinsurance, and deductibles for the administration of the H1N1 vaccine.

“These significant actions are very encouraging for Maine’s consumers, and they demonstrate how Maine insurers continue to take voluntary steps in the face of a potential public health emergency. Although receiving the vaccine is a voluntary decision, we want to make the process as easy as possible for people,” said Superintendent Kofman.

Beginning as early as August, these insurance companies began making exceptions to the requirement that vaccinations have full Food and Drug Administration (FDA) approval before coverage would be authorized. The vaccination has since been approved by the FDA.

In September, they additionally began voluntarily accepting roster billing in order to streamline the billing process for vaccination clinics. Vaccination clinics and mass immunization allow individuals to receive the H1N1 vaccination without having to schedule an appointment with their primary care providers.

Roster billing is a simplified billing process that can make it easier for clinics and mass immunizers–such as schools, pharmacies, or workplaces–to get people immunized quickly while still providing the information insurance companies need to pay claims, in this case to pay the fee for administering the vaccine.

“Clinics and mass immunizations take the pressure off the traditional delivery system, and we want to recognize that Maine insurers are going the extra mile by modifying their systems to accept this method of billing,” said Dr. Dora Mills of the Maine Center for Disease Control.

“My staff and I have been working closely with insurance companies and with the Maine Association of Health Plans to address H1N1 issues and to be fully prepared,” said Superintendent Kofman. “We are also working closely with other State agencies, including the Maine Health Data Organization to ensure that by accepting roster billing health plans are not inadvertently violating other laws.”

The Bureau of Insurance Web site is updated regularly with information for insurance carriers, care providers and consumers. For more information, visit www.maine.gov/insurance.

The Bureau of Insurance is part of the Department of Professional and Financial Regulation which encourages sound ethical business practices through high quality, impartial and efficient regulation of insurers, financial institutions, creditors, investment providers, and numerous professions and occupations for the purpose of protecting the citizens of Maine. Consumers can reach the Bureau through its web site at www.maine.gov/insurance; by calling 800-300-5000 in state; or by writing to Bureau of Insurance, 34 State House Station, Augusta ME 04333.

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Last Updated: July 26, 2011 7:49 AM