Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Old 12-07-2011, 05:12 PM   #101
Thinks s/he gets paid by the post
 
Join Date: Feb 2007
Posts: 2,424
I was going to put this in the topic about getting jacked around by your insurance company but I thought I'd post this here.

Our insurance booklet (from Jan, 2011)includes the shingles vaccine in their "routine preventative" list with other vaccines (flu, pneumonia) that are covered at 100% with no deductible. I called in August to check about it and was told that there is no minimum age, the only requirement is that you get it through your doctor's office, not a pharmacy. Next time that I was at the doctors I asked about the shingles vaccine. I had the shot in Nov.

The claim was denied! I called when I saw the claim online and was told that in September the age restriction was changed to age 60, RETROACTIVE TO JAN 1, 2011!!

The person I spoke with about the denial was the same one that I talked to in August, my call was in their notes. She said that she would send the claim to her supervisor for review.

WTF! How can they change the age requirement retroactively? Are they going to go back and try to recoup from claims they already paid?

If I would have known, I easily could have waited until I was 60 for this. I thought I did the correct thing in calling about this ahead of time so that all went smoothly. But no, I'm dealing with a medical insurance company and they can do whatever they want. Right now it shows that I will owe $205, so that gives me plenty of incentive to follow through on getting this paid.
__________________

__________________
Married, both 62. DH retired June, 2010. I have a pleasant little part time job.
Sue J is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 12-09-2011, 09:12 AM   #102
Full time employment: Posting here.
 
Join Date: Dec 2010
Posts: 746
Age 60 was the "old" requirement. The age was lowered to 50 sometime in late March or early April. I don't know what insurance you have; however, my Humana did not have an age requirement. Spouse has Aetna and they lowered the age to 50.
__________________

__________________
East Texas is offline   Reply With Quote
Old 12-09-2011, 09:30 AM   #103
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,290
Quote:
Originally Posted by East Texas View Post
Age 60 was the "old" requirement. The age was lowered to 50 sometime in late March or early April. I don't know what insurance you have; however, my Humana did not have an age requirement. Spouse has Aetna and they lowered the age to 50.

And I have Humana and they did not cover it no matter what age....


There are many plans under any company.... not every plan covers the same things....
__________________
Texas Proud is offline   Reply With Quote
Old 12-09-2011, 10:22 AM   #104
Full time employment: Posting here.
Lakedog's Avatar
 
Join Date: May 2007
Posts: 654
I think many health insurance cos use CDC guidelines (still age 60), but some use the FDA approval (lowered to age 50). I know my federal health plan still uses age 60 - I called to ask if they would soon lower the age to 50, their reply was "only if the CDC changes their guideline".

My doc will give it to me prior to age 60, price is $200 out of pocket. Although you can get shingles at any age, he said most cases he sees (by far) are people above 60. He is around my age (55) so I asked if he had gotten the vaccine -- said he would likely wait until around age 60. I still haven't decided but may go ahead with it, was hoping CDC would change their guideline sooner rather than later.
__________________
Lakedog is online now   Reply With Quote
Old 12-09-2011, 11:27 AM   #105
Thinks s/he gets paid by the post
 
Join Date: Jan 2005
Posts: 2,555
My federal health plan, BC/BS, told me they would cover if 50 or older. I called them within the last month. I have my prescription and was waiting for my DH to get his and then go together. I guess that I will call ins co the day I go and make sure that I get the same answer and document who gave me the information.
__________________
Dreamer is offline   Reply With Quote
Old 12-09-2011, 11:50 AM   #106
Full time employment: Posting here.
Lakedog's Avatar
 
Join Date: May 2007
Posts: 654
Quote:
Originally Posted by Dreamer View Post
My federal health plan, BC/BS, told me they would cover if 50 or older. I called them within the last month. I have my prescription and was waiting for my DH to get his and then go together. I guess that I will call ins co the day I go and make sure that I get the same answer and document who gave me the information.
Thanks for the info, I called mine (GEHA) about a month ago so I may try calling again after the first of the year, but it sounded as if they would not change until CDC made the recommendation.
__________________
Lakedog is online now   Reply With Quote
Old 12-09-2011, 12:17 PM   #107
Full time employment: Posting here.
misanman's Avatar
 
Join Date: Apr 2008
Posts: 536
Here's a good CDC paper on shingles and vaccination. Mentions that they are looking at whether a "booster" would be needed as effectiveness declines.

www.cdc.gov/vaccines/vpd-vac/shingles/.../shingles-vac-msg-2008.pdf

It's dated 2008 so maybe there's something more recent.
__________________
"The best thing about the future is that it happens one day at a time." -- A. Lincoln
misanman is offline   Reply With Quote
Old 12-13-2011, 10:46 PM   #108
Thinks s/he gets paid by the post
 
Join Date: Jan 2005
Posts: 2,555
DH and I both received our shingles vaccines today. Neither are 60 yet and my Fed health insurance covered it. Thanks to everyone for keeping this thread going, because I probably would not have thought about getting them before reading this thread. A friend just sent an email that her DH was in extreme pain and they found out he had shingles. He had just had knee surgery, so they were surprised that pain was from the shingles.
__________________

__________________
Dreamer is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


 

 
All times are GMT -6. The time now is 01:49 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.