Coverage for Human Monkeypox Virus Vaccination

On August 10, 2022, Commissioner Stolfi published Bulletin No. DFR 2022-4, which addresses coverage for human Monkeypox virus (hMPXV) vaccination. According to the bulletin, all health benefit plans (including grandfathered health benefit plans) in Oregon must provide coverage for approved hMPXV vaccines and their administration in accordance with this bulletin. The coverage required under the bulletin includes vaccines administered to an individual after exposure to the virus as post-exposure prophylaxis (PEP). In addition, a health benefit plan may not restrict coverage for an approved hMPXV vaccine and its administration to in-network providers and must not require employee cost-sharing for the vaccine. The coverage requirements became effective on August 5, 2022.

Employers should work closely with insurers to ensure that the coverage is provided according to the bulletin, and to address any related employee questions relating to hMPXV.

Bulletin No. DFR 2022-4 »