MedicaidCoverageMedium impact
Oregon Health Plan coverage of children’s COVID-19 and flu immunizations at OHP-enrolled pharmacies
Oregon Health Plan·OR · Pediatrics, Family Medicine, General Practice·Plan
Effective date
Oct 20, 2021
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (OHP) has waived VFC program enrollment requirements for COVID-19 and flu immunizations for children at pharmacies during the COVID-19 Public Health Emergency. Pharmacies can now bill directly for these services, with specific reimbursement rules for administration fees and vaccine costs.
Action Required
Immediately for Oregon practices: Update billing workflows to allow direct billing to OHA for flu and COVID-19 immunizations at non-contracted pharmacies for OHP-eligible children. Bill administration only for COVID-19 vaccines (serum provided free), bill both administration and serum for non-VFC flu vaccines, and administration only for VFC flu vaccines. Contact CCO Account Representative for specific reimbursement arrangements.