New Shingrx Shingles Vaccine

[omni550]

I just stopped by the pharmacy at the nearby Walmart and asked about the Shingrx vaccine. They said they will start offering the Shingrx vaccine beginning on April 12, at a cost of $167/shot --- with 2 shots required (2 to 6 months apart).

omni

 

[CaptTom]

Got my first Shingrx shot today. Here's what I found:

My prescription coverage (CVS/Caremark) did NOT cover the shot.
My medical plan (a middle-of-the-road Cigna plan) covered it at 100%

After they checked both of these at the pharmacy counter, I was given a brief form to fill out (Are you feeling well today, any allergies, etc.) and I got back in line at the pick-up counter. When my turn came, they rang it up at $0.00 and I sat down for a few minutes until the pharmacist came to bring me to the little room out back where she administered the shot. Quick, nearly painless and free!

In 2-6 months I'll go back and get the 2nd shot.

 

[omni550]

I just called Aetna (my Medicare supplemental Part G insurer) to check if they might cover it. They said they will only cover it (at 20%) if Medicare covers it (at 80%).

Checking the internet, I could not find any evidence that Medicare is covering the Shingrx vaccine yet.

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I did see that GoodRx is now showing $147.57(@ Costco, Meijer's, etc.) to $161 (@RiteAid) per shot as local pricing with their coupon combined with my cheapest Part D (through EnvisonRXPlus.)

omni

 

[braumeister]

Just got a flyer in the mail from my local (Kroger) pharmacy inviting me to get this. They say "most insurance plans cover it" so that's encouraging. I plan to ask my doc about it when I see him in a few months. Had the previous vaccine (also had shingles).

 

[gauss]

I just called Aetna (my Medicare supplemental Part G insurer) to check if they might cover it. They said they will only cover it (at 20%) if Medicare covers it (at 80%).

Checking the internet, I could not find any evidence that Medicare is covering the Shingrx vaccine yet.

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omni

My brief research suggests that Part B Medicare never covered Zostavax -- only some Part D prescription plans or some Part C Medicare Advantage plans.

Has anyone with only Part A/B + Supplemental/Medigap plan ever had Zostavax covered in a preventative fashion?

-gauss

 

[CaptTom]

I forgot to mention; I'd already asked my Dr. about this, and he'd have been happy to write a prescription, but CVS didn't require one.

 

[GTFan]

Checked this out at Kroger pharmacy and it's covered by my plan (Ambetter) but has to be prescribed by my doc first.

 

[Ally]

I called yesterday and our insurance covers it at 100%, so we will go to Walgreens this week.

 

[Lsbcal]

This article was just published in the NY Times. It is very positive on the new drug:

https://www.nytimes.com/2018/04/09/well/why-you-should-get-the-new-shingles-vaccine.html

 

[gerntz]

Got my first shot today. $0 with my medicare supplemental.

 

[travelover]

Got my first shot today. $0 with my medicare supplemental.

Covered by B or D supplement?

 

[gerntz]

Covered by B or D supplement?

We don't have Medicare Part D. I didn't ask Walgreens what part of my coverages paid.

 

[ExitLeft]

CVS told me 50-59 yo requires a prescription, while >60 doesn’t.

I went back to the same CVS and was able to get the shot and they did not say I needed a prescription, so the first person must not have known that Shingrix is good for 50+. The $167.99 was fully covered by my insurance (I think it was via my CVS Caremark prescription card).

I did have one of the listed side effects. I got the shot around 2pm. At 2am, I awoke shivering and couldn't get warm, no matter how many layers I covered up under. The shivering lasted about 3 hours. It was a long, sleepless night and I feel hungover today. But it is a known side effect, according to the paperwork, and shouldn't dissuade from getting the follow-up shot.

 

[testing321]

Covered by B or D supplement?

D

 

[Ally]

I got the immunization yesterday and am sick as can be. I feel like I have the flu and I have a fever of 100.8. I looked it up on the CDC website and says 1 out of 6 have these types of side effects. I'm glad I did it, but it sure made me feel bad!

 

[boog]

DW and I got our shots this past Wednesday at local Walgreens. Pharmacist warned us to expect some level of reaction with rash. Neither of us had a rash but our arms were both really sore for a couple of days - but certainly not comparable with dealing with shingles.

 

[gerntz]

DW and I got our shots this past Wednesday at local Walgreens. Pharmacist warned us to expect some level of reaction with rash. Neither of us had a rash but our arms were both really sore for a couple of days - but certainly not comparable with dealing with shingles.

Why were both arms sore? Mine - just one - got sore, not really sore, for 3-4 days. Felt like a bruise.

 

[KB]

I got the Shingrix vaccine in one arm and the first Pneumonia vaccine in the other, earlier this week. One arm was very sore and had a rash. The other was only slightly sore. I forgot to write down which was which, but it sounds like the Shingrix is the one that was most sore.

 

[Z3Dreamer]

I have not been a fan of vaccines but a moment of sense broke through my fog. DW and I have a Thursday "Date" where we go to the gym (Senior Sneakers for her), then get our 5% Senior discount at chain grocery store. Decided to include a trip to local vaccine pharmacy as part of our Date. This was helped by our BCBS HSA policy covering many vaccines at 100%. So far we have done part 1 of Shingrix, one of the pneumonia shots and whatever they call the combo-tetanus shot these days. Have the second Shingrix on my calendar as well as the second pneumonia in a year. Ain't I a fun Date?

 

[timo2]

My doctor wrote a prescription for me to use at my pharmacy as his clinic did not have Shingrix yet. But I've tried two pharmacies so far and both are out of the vaccine but expecting shipments soon.

 

[wmc1000]

Shringrix now shows up in the medicare.gov drug plan search for plans when you enter it in the drug section. Many of the Part D plans have it classified as a tier 3 drug.

Initial Coverage Level is around $44 per shot but the kicker is whether your Part D plan has a deductible and whether you already have met that.

In our case we have a $405 annual deductible per person and since our routine drugs are all generics we don't reach our deductible limit so Shingrix would cost us approx $164 per shot.

 

[Dtail]

Florida Blue ACA fully covers Shringrix, but DGF on Medicare Advantage must pay a copay.
It appears that Medicare doesn't seem to cover this shot quite as well for now.

 

[Telly]

Hopefully the cost coverage of ShingRix will expand out real soon.

The 2018 CDC Recommended vaccines vs. age, effective February of this year, lists RZV (ShingRix) as recommended for ages 50 and above. The ZVL listed is the Zostavax vaccine, of which many of us have already gotten.

The Pneumonia vaccine(s) still say age 65 and above for recommended. For age 64 and under, "may be recommended" if you have risk factors. I don't think the "may be recommended" level are covered by insurance plans, ours doesn't.

https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf

It appears our present insurance would cover ShingRix, as the plan specifies it covers all Recommended vaccines on the CDC recommendation list. I should get both ShingRix shots before Medicare, seems simpler to just get them when the $ path is easy and documented!

 

[littleb]

DH and I had our first Shingrx shot a few weeks ago. The dr. recommended the new vaccine even though I had the old shingle shot a few years ago.

We both had a very sore arm where the injection was given but my arm was sorer, redder and warm to the touch compared to DH. A few days after the shot the rash appeared on my arm around the injection area and lasted about a week. DH did not have these side effects. This will prepare me for the possibility of similar side effects with shot number 2.

Btw BCBS of Tennessee paid for the shots at 100% and with no deductible.

 

[Janet H]

I am covered under FEP Blue Cross/Blue Shield and called them last week to see if they cover the new vaccine. She told me that they do not cover it yet. They did cover the older shingles vaccine for me when I was in my 50's. I did get Shingles after receiving the vaccine, but had a very mild case. I plan on getting the new vaccine as soon as insurance covers it.

FEP Blue covered this fully for me - got the first jab 4 days ago at the local grocery store pharmacy. A day later a very sore arm and then small fever and some nausea that lasted for two days. Today (4 days later) my arm is till tender. My DH had no side effects - go figure. Still, I watched a dear friend lose sight in an eye as a result of shingles so this seems like a reasonable trade off for protection against that possibility.

Looking forward to the next round...