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Vaccines for Children (VFC) Program Patient Eligibility Screening

Vaccines for Children (VFC) Program Patient Eligibility Screening 2025

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The document outlines the Vaccines for Children (VFC) Program Patient Eligibility Screening Record Form, which is used to determine and document the eligibility of children aged 18 and under for publicly funded vaccines during immunization visits. It specifies the requirements for maintaining records, eligibility categories, and instructions for healthcare providers on how to complete the form. The form must be retained for three years and includes guidelines for assessing eligibility based on insurance status.

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Versions	Form popularity	Fillable & printable
2024	4.7 Satisfied (40 Votes)
2019	4.6 Satisfied (39 Votes)
2014	4 Satisfied (32 Votes)

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When are providers required to screen patients for VFC eligibility?

VFC providers must screen every patient under 19 years old for program eligibility at each immunization encounter and document their eligibility status. VFC vaccines can only be administered to children who meet the eligibility criteria.

Who is eligible to receive VFC vaccines?

Children ages 18 years or younger who are enrolled in a Medicaid program or are eligible for Medicaid can receive VFC Program benefits. However, children who are enrolled in a separate CHIP program are considered insured and do not qualify for VFC Program benefits.

Who is eligible for VFC in Michigan?

Children through 18 years of age who meet at least one of the following criteria are eligible to receive VFC vaccine: Medicaid eligible: A child who is eligible for the Medicaid program. Uninsured: A child who has no health insurance coverage. American Indian or Alaska Native.

What are the requirements for VFC reporting?

In ance with federal law, VFC providers must maintain immunization records that include ALL of the following elements: (1) name of vaccine administered; (2) date vaccine was administered; (3) date VIS was given; (4) publication date of VIS; (5) name of vaccine manufacturer; (6) vaccine lot number; (7) name and