January 9, 2018
Salem — In November, the public health director of the Oregon Health Authority declared a meningococcal disease outbreak at Oregon State University. This uncommon, but rapidly progressive, infection may be fatal unless treated with prompt antibiotic therapy.
According to Oregon law, the declaration by the public health director requires insurers offering health plans in the state to provide necessary vaccinations, consistent with their policy contract, to prevent the spread of the disease.
Oregon State students age 25 and younger are required to get vaccinated by Feb. 15. Oregon-based health insurance providers are required to cover this necessary vaccination.
The law also restricts insurers from:
- Requiring the services to be administered by an in-network provider
- Imposing cost-sharing requirements greater than the cost-sharing requirements of similar covered services
- Requiring prior authorization
- Limiting coverage in any manner that prevents a customer from receiving necessary health services
The services can be administered by out-of-network providers such as pharmacists and be presented to insurers as either a medical benefit or a pharmacy benefit.
Health insurance plans purchased out-of-state are not required to offer this coverage.
Students are encouraged to visit Oregon State University’s Student Health Services at http://studenthealth.oregonstate.edu/student-vaccine-clinics for more information.
Consumer advocates from the Oregon Department of Consumer and Business Services are available at 888-877-4894 (toll-free) for students that have trouble with their insurance benefits.
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