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Plan-specific coverage and reimbursement

The materials available on this page provide Merck product coverage information regarding various third-party payers. Merck cannot guarantee that use of the information available from this site will always result in patient having coverage for the product or that the amount of reimbursement will cover your costs. The availability of coverage and/or the reimbursement rate can vary based on, for example:

  • the patient’s health benefit design
  • your contract with the payer
  • and/or the patient’s coverage status

You should contact health plans directly to ensure that you have the most accurate and timely information on:

  • coverage for the product
  • any patient out-of-pocket costs
  • correct billing processes

Plans listed herein have reported to Merck that the plan has adopted coverage for the relevant Merck product without regard to the plan’s rate of reimbursement.

Plan-specific information for health care providers

Please note that the plan-specific information materials listed as a result of your search do not necessarily include a complete list of all Commercial, Managed Medicaid, Medicaid Fee for Service, or Medicare Plans that may reimburse for the Merck product. If you do not see a specific plan, please contact the plan directly.

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aPlan types

Choose from the following plan types:

Commercial – CAPVAXIVE™ (Pneumococcal 21-valent Conjugate Vaccine)

Pharmacy Commercial – CAPVAXIVE™ (Pneumococcal 21-valent Conjugate Vaccine)

Medicaid – CAPVAXIVE™ (Pneumococcal 21-valent Conjugate Vaccine)

Medicare – CAPVAXIVE™ (Pneumococcal 21-valent Conjugate Vaccine)

Commercial – GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant)

Managed Medicaid – GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant)

Medicaid Fee For Service – GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant)

Pharmacy Commercial – State – GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant)

Pharmacy Commercial – PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent)

Commercial – VAXNEUVANCE® (Pneumococcal 15-valent Conjugate Vaccine)