Uninsured and Underinsured Adult Vaccine
MDH, with federal funding, is providing vaccine to uninsured and underinsured adults (19 years and older) through 157 clinics throughout the state. These clinics were selected through an application process in October 2013 and will participate in this program through September 2016. This program is referred to as UUAV (uninsured and underinsured adult vaccine).
- Minnesota Uninsured and Underinsured Adult Vaccine Program Annual Provider Agreement 2015 (PDF: 63KB/2 pages)
- Uninsured and Underinsured Adult Vaccine (UUAV) Program Policies and Procedures (PDF: 171KB/1 page)
Instructions for participating in the UUAV program for 2015.
- Semi-Annual Report of Doses Administered with Vaccine from MDH to Uninsured and Underinsured Adults (PDF: 110KB/1 page)
Reporting for Oct. 1, 2014 - March 31, 2015 is due May 31, 2015.
- Vaccine Order Form (PDF: 48KB/2 pages)
Order form for UUAV. Updated 12/14
- 2015-16 UUAV Influenza Vaccine Late Order Form (PDF: 114KB/1 page)
- Patient Eligibility Screening Record (PDF: 23KB/1 page)
Screening record for the UUAV clinics. Updated to include Medicare patients as an option. 5/14
- Billing Office Tips on UUAV (PDF: 31KB/1 page)
Clinics enrolled in the UUAV program can use these tips for billing purposes.
- Other Forms
Returning nonviable vaccine, vaccine transfer record and the vaccine restitution appeal forms.
- Vaccination Clinics Serving Uninsured and Underinsured Adults
Search for clinics with free vaccine for qualifying uninsured and underinsured adults.
- Uninsured and Underinsured Adult Vaccine Promotion Toolkit
Resources for clinics to promote the availability of free or low-cost vaccine for adults without insurance or whose insurance does not cover the cost of vaccines.
- For Health Care Providers Serving Adults
Resources to help you make sure adult patients get the immunizations they need.