Uninsured and Underinsured Adult Vaccine
MDH, with federal funding, is providing vaccine to uninsured and underinsured adults (19 years and older) through 109 clinics throughout the state. These clinics were selected through an application process in January 2011 and will participate in this program through December 2013. This program will be referred to as UUAV (uninsured and underinsured adult vaccine).
- 2014-15 UUAV Influenza Vaccine Order Form (PDF: 56KB/1 page)
- Minnesota Uninsured and Underinsured Adult Vaccine Program Annual Provider Agreement 2014 (PDF: 62KB/2 pages)
- Minnesota Uninsured / Underinsured Adult Vaccine Program Policies and Procedures Manual October 2013 - September 2014 (PDF: 424KB/62 pages)
Policies and procedures manual for clinics in the UUAV program.
- Semi-Annual Report of Doses Administered with Vaccine from MDH to Uninsured and Underinsured Adults (PDF: 44KB/1 page)
- Vaccine Order Form (PDF: 49KB/2 pages)
Order form for UUAV.
- Patient Eligibility Screening Record (PDF: 23KB/1 page)
Screening record for the UUAV clinics.
- 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.