Adult Vaccinations

[b2bailey]

I'm one who has decided to forego the 'flu shot' even though my doctor is a heavy promoter. She did convince me (yesterday) to say yes to pneumonia and diptheria/tetanus. I feel fine, however I am surprised by the lingering pain in each arm at injection site.

I'm willing to consider the Shingles vaccine, but they do not offer it in office. Was told I have to place my name on list at Pharmacy and will be called when they have it in stock. Anyone familiar with this process?

 

[Passepartout]

Ask at your pharmacy how they do it. As it worked out, I got 'shot 1' at my PCP's office and when it was time for #2, they were out, so I called around and found availability at Walgreen's (not my 'regular' pharmacy), but it worked fine. Covered by Medicare and insurance zero out of pocket cost to me. As others have mentioned, the Shingrix is more painful, but clearly less so than shingles! Do more than 'consider' it.

Jim

 

[easyrider]

Walmart has the shingles shot. It took about 30 minutes to get my wife and I the shot. Then we went for a bit grocery shopping. Seemed like a productive day, lol.

Bill

 

[LisaH]

Thanks. I'll check Walmart out. I had Shingle outbreak while I was on a Tradewinds cruise in French Polynesia. It was so painful that I would not wish on my worst enemy.

 

[clifffaith]

Vons, and I presume some other grocery store pharmacies, gives out 10% off groceries coupons with injections. At this time of year that's worth easily $15-20. Cliff balked at paying $70 for a flu shot at CVS the other day, so we're trying Vons today where I, his know it all wife, expect the price to be the same (due to his insurance plan), but at least we'll get a few bucks back using the coupon.

 

[Luanne]

@b2bailey With the Shingrix vaccine I was lucky in that I walked into the pharmacy I like to use for shots and they had it available. So I got the first shot. Dh went in two days later and they were out. He ended up putting himself on lists at a couple of pharmacies and was finally called by the one at Market Street (formerly Albertson's). We have both had the second shot as well. We were both put on lists after the first one as those who have already had the first shot have priority. Besides being on the list I kept calling the pharmacy where I'd gotten the first shot.

My bil when to CVS minute clinic and was able to walk in and get the first shot that day.

@clifffaith Your husband is getting charged for flu shots? Ours have always been covered by Medicare.

 

[VacationForever]

Vons, and I presume some other grocery store pharmacies, gives out 10% off groceries coupons with injections. At this time of year that's worth easily $15-20. Cliff balked at paying $70 for a flu shot at CVS the other day, so we're trying Vons today where I, his know it all wife, expect the price to be the same (due to his insurance plan), but at least we'll get a few bucks back using the coupon.

Don't all health insurance cover flu shots?

 

[Passepartout]

Don't all health insurance cover flu shots?

All REAL insurances cover preventative vaccinations (it's one of the ACA provisions), but the cost applies to the annual deductible on those low-premium, high deductible plans. On those, the patient pays for EVERYTHING health related until the deductible is met.

 

[BarbmC]

My local Shop Rite had the Shingrix Vaccine - no charge with my insurance!

 

[VacationForever]

All REAL insurances cover preventative vaccinations (it's one of the ACA provisions), but the cost applies to the annual deductible on those low-premium, high deductible plans. On those, the patient pays for EVERYTHING health related until the deductible is met.

I am also thinking that since Cliff is on Medicare and vaccinations should have been free.

Even low premium high deductible plans cover flu shots for free.

 

[Luanne]

I need to get a measles vaccine. Had the blood titer and found I am not immune. The pharmacy was telling me they couldn't tell me what the cost would be until they ran it through my insurance. I have Medicare. I think it should be covered, but these days who knows.

 

[controller1]

Nor familiar with the waiting list. My local Walgreen's had the Shingrix vaccine in stock and I was able to get the shot within ten minutes of completing the paper work.

 

[Luanne]

Nor familiar with the waiting list. My local Walgreen's had the Shingrix vaccine in stock and I was able to get the shot within ten minutes of completing the paper work.

The waiting list is used in those locations where they don't have the vaccine on hand. In our area, and I don't know if this is still the case, they never knew how much of the vaccine they would receive each time they got more.

 

[clifffaith]

Don't all health insurance cover flu shots?

You'd think so. Vons also wanted $70. Now he's going back to our GP, from whence he started. I am washing my hands of it.

 

[clifffaith]

I am also thinking that since Cliff is on Medicare and vaccinations should have been free.

Even low premium high deductible plans cover flu shots for free.

I agree. Don't know why they want to charge him, but they all cite "your insurance" which is HealthNet HMO. He swears in past years he did not pay. But by now he's been to CVS, Vons, and the place the GP sent him and they all want the $70 his insurance apparently calls for. Time to pay up.

 

[Luanne]

I agree. Don't know why they want to charge him, but they all cite "your insurance" which is HealthNet HMO. He swears in past years he did not pay. But by now he's been to CVS, Vons, and the place the GP sent him and they all want the $70 his insurance apparently calls for. Time to pay up.

I know you want to stay out of it, but it might be time for a call to HealthNet.

 

[klpca]

I need to get a measles vaccine. Had the blood titer and found I am not immune. The pharmacy was telling me they couldn't tell me what the cost would be until they ran it through my insurance. I have Medicare. I think it should be covered, but these days who knows.

I just had my titers done yesterday and am waiting to hear if I need to update my vaccinations, or even if I *can* update my vaccinations. My RA meds are immunosuppressants, which causes all kinds of fun - I can't get live vaccinations and I also worry about getting a contagious disease since folks are choosing to forgo vaccinations. I get every shot that I can.

 

[clifffaith]

I know you want to stay out of it, but it might be time for a call to HealthNet.

I suggested he do that this afternoon, and could tell from my office that he was on the phone since light was lit, so hopefully that's what he was doing. (In the time I spent writing this and being interrupted several times, he called and yes he has to pay). We went to an Aetna presentation last week and I think he's considering changing. He's not happy with the long waits for referrals and then hospital surgical appts that he has experienced with Healthnet this year. Of course he's never had anything wrong before. This has been his year -- first squamous cell carcinoma on his hand that grew from a dime size to a fat quarter size while he waited, and now he has a December 23 appt (sigh for the date and for the office being right next to the Long Beach airport at holiday time) for the same type of cancer on his cheek, but a different (Moh's) type of surgery. I'm worried about that one because his "scent" has changed. He no longer smells like Cliff and that worries me that I'm smelling "cancer" like the cancer sniffing dogs. We are planning nothing for Christmas until we see how he feels -- will probably make it a pasta meal where I'm not trying to shop for fresh ingredients at the last minute since they've told him to plan to be in surgery all morning on the 23rd. Big dish of lasagna also travels easily to my parent's home since they are both pretty much bed or chair bound at this point.

 

[bogey21]

He's not happy with the long waits for referrals and then hospital surgical appts that he has experienced with Healthnet this year...

I buy insurance for a derelict Son age 48 who lives with his Mother and has no income and obviously is not eligible for Medicare. Before you all tell me I am stupid to buy him health insurance I'll tell you why I do. It is because Medicaid in Illinois sucks and if something serious happens to him, his Mother will put the heavy on me to cover his medical bills and bad mouth me to our other more responsible kids if I don't. I know. It is blackmail but I can afford it...

Yesterday I bought him a policy from Blue Cross Blue Shield Illinois. Here I address the referrals issue. The price difference between relatively similar PPO and HMO policies was only $18 per month with the PPO obviously being the more expensive. My thinking is "why in the world would anyone go for the HMO to save a paltry $18 a month?"...

 

[Luanne]

I buy insurance for a derelict Son age 48 who lives with his Mother and has no income and obviously is not eligible for Medicare. Before you all tell me I am stupid to buy him health insurance I'll tell you why I do. It is because Medicaid in Illinois sucks and if something serious happens to him, his Mother will put the heavy on me to cover his medical bills and bad mouth me to our other more responsible kids if I don't. I know. It is blackmail but I can afford it...

Yesterday I bought him a policy from Blue Cross Blue Shield Illinois. Here I address the referrals issue. The price difference between relatively similar PPO and HMO policies was only $18 per month with the PPO obviously being the more expensive. My thinking is "why in the world would anyone go for the HMO to save a paltry $18 a month?"...

But, from what I've heard some people can find a Medicare Advantage Plan with no premium. In most cases it is an HMO. The Medicare Supplement plans, which pretty much allow you to see any doctor WHO ACCEPTS MEDICARE, can run much more. I'm paying $155/month this year, next year it will be $125/month as I'm switching to a different carrier. Dh paid $180/month this year. We both have Plan F, which probably offers the most coverage.

So you can't really compare your son's case to someone on Medicare. Or, are you saying because he qualifies for Medicaid he's in a whole different category?

 

[bogey21]

You are right. This is not a Medicare issue. It is totally a totally irresponsible Son and irresponsible Mother issue. My only point in telling my story was to point out the small cost differential between the PPO and HMO policies at least with Blue Cross Blue Shield in Illinois...

George

 

[VacationForever]

I agree. Don't know why they want to charge him, but they all cite "your insurance" which is HealthNet HMO. He swears in past years he did not pay. But by now he's been to CVS, Vons, and the place the GP sent him and they all want the $70 his insurance apparently calls for. Time to pay up.

I believe Healthnet HMO is similar to Kaiser HMO in some ways. When we were with Kaiser, you must get shots through Kaiser, for free. If you go outside of Kaiser you foot the whole bill for vaccination. Can Cliff get it through his doctor?

 

[Luanne]

I believe Healthnet HMO is similar to Kaiser HMO in some ways. When we were with Kaiser, you must get shots through Kaiser, for free. If you go outside of Kaiser you foot the whole bill for vaccination. Can Cliff get it through his doctor?

Back in post #15 she said that Cliff's doctor sent his someplace for the shot, and that place wanted to charge him.

 

[VacationForever]

Back in post #15 she said that Cliff's doctor sent his someplace for the shot, and that place wanted to charge him.

I read that. But I am also thinking that HMOs do offer free preventative vaccinations. They need to find out where they need to go to for their insurance covered shots.

 

[controller1]

I agree. Don't know why they want to charge him, but they all cite "your insurance" which is HealthNet HMO. He swears in past years he did not pay. But by now he's been to CVS, Vons, and the place the GP sent him and they all want the $70 his insurance apparently calls for. Time to pay up.

From the Federal Department of Health & Human Services: Flu and other vaccines are required to be covered by your health insurance without charging a copayment or coinsurance. ... Some insurance plans only cover vaccines given by your doctor or at a limited set of locations.

It appears the $70 is because it is at a location not covered by the insurance plan.