MedicaidCoverageMedium impact
BT2023107: IHCP removes cost-sharing obligations for pharmacist-administered adult vaccines
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice·Provider Bulletin
Effective date
Oct 1, 2023
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) will eliminate member cost-sharing for all FDA-approved, CDC-recommended adult vaccines administered by pharmacists effective October 1, 2023. This applies to pharmacy-administered vaccines for IHCP members 19 years and older, with COVID-19 vaccines remaining carved out to Optum Rx.
Action Required
By October 1, 2023: Billing team must verify that pharmacy claims for adult vaccines to Indiana Medicaid members show no member cost-sharing. For managed care members (HIP, Hoosier Care Connect, Hoosier Healthwise), contact the specific MCE for vaccine coverage questions. For COVID-19 vaccines and FFS members, submit pharmacy claims to Optum Rx at 855-577-6317.