New Empire Plan Vaccine Benefit

A new vaccine called Gardasil, which is designed to prevent cervical cancer and other conditions caused by the human papillomavirus (HPV), is now a covered benefit under the Empire Plan. The effective date of coverage is June 29, 2006, which is the date Gardasil was endorsed by the Advisory Committee on Immunization Practices (ACIP).

As recommended by the manufacturer of Gardasil and the ACIP, the Empire Plan will provide benefits for the vaccine for girls and young women ages 9 to 26. Dependent females up to the age of 19 will be eligible to receive the HPV vaccine under the terms of the pediatric immunization program, and eligible females ages 19 to 26 will receive coverage under the adult immunization program. Under the adult immunization program, the vaccine must be administered by a participating provider for it to be a covered benefit.

The state Insurance Department now requires all health plans to offer coverage for immunizations for dependent children to age 19 recommended by the Advisory Committee on Immunization Practices, so HMO enrollees will have a similar benefit. HMO enrollees should contact the Member Services department of their HMO for more information.

If you have any questions about this new benefit, contact Health Benefits at 1-800-342-4306 or 518-785-1900 ext. 283.