​​DATE:  September 23, 2026

TO:      All Interested Parties Including Insurers, Non-Profit Health Service Plans, and Health Maintenance Organizations

RE:      Public Health – Recommendations for Immunizations, Screenings, and Preventive Services (The Vax Act)

This Bulletin is issued by the Maryland Insurance Administration (the “Administration") to provide guidance to health insurers, nonprofit health service plans, and health maintenance organizations regarding the newly released statewide 2026 – 2027 vaccine schedules and recommendations for Maryland's children and adults. [1] 

Background and Authority 

As background, House Bill 974, Chapter 745, Acts of 2025 amended the Administration's enforcement authority for the Affordable Care Act preventive services coverage requirements under § 15-1A-10. The bill required the Administration to enforce those requirements consistent with the U.S. Preventive Services Task Force (“USPSTF"), the Advisory Committee on Immunization Practices (“ACIP"), or the Health Resources and Services Administration (“HRSA"), recommendations and guidelines, as well as related federal rules or guidance, that were in effect on December 31, 2024.  The bill also authorized the Maryland Insurance Commissioner (the “Commissioner") to adopt regulations to require carriers to cover, without imposing cost-sharing, any future preventive services recommendations and guidelines issued after December 31, 2024, that enhance the scope of preventive services to the benefit of Maryland consumers. 

House Bill 1315, Chapter 738, Acts of 2025 made similar changes to the mandated benefit for child wellness services under § 15-817 of the Insurance Article. This bill specified that carriers were required to cover the childhood and adolescent immunizations recommended by ACIP as of December 31, 2024. Furthermore, the bill authorized the Commissioner to adopt regulations to require carriers to cover any future ACIP recommendations issued after December 31, 2024 for new vaccines. 

Effective July 1, 2026, the Vax Act (Senate Bill 385, Chapter 8 Public Health) requires the Maryland Department of Health (the “MDH") to issue recommendations for immunizations, screenings, and preventive services based on evidence-based scientific and clinical guidance from authoritative bodies, including the USPSTF, the ACIP, and the HRSA.  The Vax Act, codified as Health - General §18-112, outlines the specific process MDH must follow prior to adopting a new recommendation. In addition, the Vax Act requires MDH to publish the recommendations on its website and to distribute the recommendations to the Administration. 

On September 10, 2026, the MDH released statewide 2026-2027 vaccine schedules and recommendations for Maryland's children and adults. The recommended vaccinations are required to be covered with no out-of-pocket costs by certain regulated insurance plans, as described below. 

Applicability 

In identifying the insurance plans affected by the Vax Act, the applicability of §§ 15-1A-10 and 15-817 has not changed.  Section 15-1A-10 continues to apply to non-grandfathered health benefit plans issued by insurers, nonprofit health service plans, and health maintenance organizations in the individual, small group, and large group markets.  Section 15-817 continues to apply to grandfathered and non-grandfathered large group health benefit plans, grandfathered individual health benefit plans, and any other health insurance contracts that both provide hospital, medical or surgical benefits on an expense incurred basis and provide coverage for a family member of the insured. As was the case prior to the enactment of the Vax Act, Section 15-817 does not apply to health maintenance organization contracts. 

The effective date of the Vax Act is July 1, 2026, and the insurance provisions apply to contracts issued, delivered, or renewed in Maryland on or after January 1, 2027. 

The vaccines recommended by MDH are supported by experts at the MDH as well as by the nation's leading medical groups, including the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists. The MDH's released statewide 2026-2027 vaccine schedules and recommendations for Maryland's children and adults may be found at the following links:

Maryland Childhood Immunization Schedule, the recommended Child and Adolescent Immunization Schedule for ages 18 years or younger

Adult Immunization Schedule, the recommended Adult Immunization Schedule by Age Group and Medical Condition 

Questions about this Bulletin may be directed to the Life/Health Section of the Maryland Insurance Administration, 200 Saint Paul Place, Suite 2700, Baltimore, MD 21202, or call at 410-468-2170.

MARIE GRANT
Commissioner

By:

Megan Mason
Associate Commissioner
Life and Health

[​1] All statutory citations herein are to the Insurance Article of the Maryland Code, unless otherwise noted.