Shingles Shots Saga

[JakeBrake]

DW and I decided it was about time for us to get our once in a lifetime shingles shots. We are both on Medicare. Traditional Medicare does not cover shingles shots. I'm told that ALL Medicare part D plans cover shingles shots. However, we don't have Medicare part D coverage. We have My MegaCorp Medigap coverage through United Healthcare. So, I called UHC and they said shingles shots were covered 100% under my policy. Then I called my primary care doc. His office said he did not do shingles shots, but they provided a list of pharmacies that would administer the shots. We went to the nearest Kroger Pharmacy. everything was moving right along until they checked my UHC coverage. They had never heard of such a thing. We get all our prescriptions through CVS Caremark, either mail order or at the nearest CVS store. This has worked very well in the past. However, the CVS stores around here do not give shingles shots. While we were still at the Kroger Pharmacy, I called UHC again and told them that Kroger would not accept my UHC coverage. The cost at Kroger without insurance was $240 each. This time UHC said we had we had to go to either Rite Aid or Walgreens. We proceeded to the nearest Walgreens. Again, things were going well until the pharmacist asked if we had had our flu shots. We did get our flu shots two weeks ago at CVS. She said we could not get shingles shots until 4 weeks after the flu shots. Personally, I'm not sure that's correct. I can't find that in my online research. I did find that shingles shots and pneumonia shots must be separated by 4 weeks. Anyhow, only two more weeks and we can try again.

[gromit]

I haven't had a shingles shot yet, but when I wanted a flu shot under my employer's UHC plan, they would cover it only if it was given in a doctor's office. I don't know why the plan's approved pharmacies were not also approved for giving flu shots.

[Bram]

I had my pneumonia & shingles vaccines on the same day, this past August. The pneumonia was @ the dr's office, then the shingles @ a local pharmacy (both covered by our Medicare secondary insurance). The pharmacist apologized for the wait (10-15 minutes?) & explained that he researched the safety of receiving both the same day. He said one source said "no", but the CDC said "yes, safe".

I had no untoward effects. I got my flu shot a couple months later, nearer to flu season.

[travelover]

Walgreen pharmacist refused to give me the shingles shot because I was only 59 1/2 not 60. We had a blood pressure raising discussion, then he gave me the darn shot - $240 out of pocket because BCBS only covers at a later age and in a doc's office.

I didn't like it, but not going to risk shingles for a few bucks.

[EveryLady]

Quote:

Originally Posted by travelover . . . $240 out of pocket because BCBS only covers at a later age and in a doc's office.

This is a perfect example of why approaching healthcare as a consumer is so doggone tricky. My BCBS plan covered the shingles shot last year at pharmacy when I was 58 without a blip. Different BCBS plan, different state etc. etc ... it varies and yah never quite know until you need it.

Next week - theoretically - the removal of DD's wisdom teeth will be covered. The oral surgeon is to submit charges using dental codes (not covered) and the local BCBS will *recode* the procedure as medical. Fingers crossed ...

[imoldernu]

We rec'd shingle shots 3 years ago, but it was on Medicare D. Shots were free, $6 charge for administering.

A few things... First the shots must be refrigerated, and even at that have a short life (according to the pharmacist). Our local Walgreens advertised them on their outside sign a week ago. Don't know if this is a permanent thing. When we got ours, only one drugstore in town of 18,000 people offered the shots.

At the time we did get ours, there were two local clinics that advertised free shots (plus a $20 service charge for administering), but that was a twice a year deal, and you had to know about the dates.

Go to your state's senior services site for info on this kind of information....even if you're not 60 or 65.

[braumeister]

Funny sidelight:
My local pharmacy has a sign outside advertising the shots, which caused me great consternation not long ago. I misread the sign as "Singles Vaccine" and began wondering whether it worked to immunize you against getting married, or the other way around.

[marko]

I got my shot last week at the local pharmacy. Initially, BCBS wouldn't pay. I went home and got on the phone (hang out/surf at FIRE.com while on hold for a half hour) and plead my case.

They said that I should be covered (I was a little surprized!) because I'm over 60. Went back to the pharmacy...the pharmacist said that I was the only person ever to go back to the insurance...everyone else pays the $240.

[omni550]

I called BCBS to find out what they covered re: shingles vaccine. My policy would only cover it if administered at a doctor's office.

Doc ordered it. It took about 2 months to arrive, as it was backordered due to high demand and short supply. When it arrived, a nurse administered it.

BCBS paid 100%.

omni

[eytonxav]

I got the shot last year at Tom Thumb pharmacy, at no cost. I have BCBS, although its an EPN plan from my former megacorp.

[travelover]

Quote:

Originally Posted by omni550 I called BCBS to find out what they covered re: shingles vaccine. My policy would only cover it if administered at a doctor's office. Doc ordered it. It took about 2 months to arrive, as it was backordered due to high demand and short supply. When it arrived, a nurse administered it. BCBS paid 100%. omni

And people have the nerve to say that we don't have efficient medical services delivery.

[Ronnieboy]

Quote:

Originally Posted by imoldernu We rec'd shingle shots 3 years ago, but it was on Medicare D. Shots were free, $6 charge for administering. A few things... First the shots must be refrigerated, and even at that have a short life (according to the pharmacist). Our local Walgreens advertised them on their outside sign a week ago. Don't know if this is a permanent thing. When we got ours, only one drugstore in town of 18,000 people offered the shots. At the time we did get ours, there were two local clinics that advertised free shots (plus a $20 service charge for administering), but that was a twice a year deal, and you had to know about the dates. Go to your state's senior services site for info on this kind of information....even if you're not 60 or 65.

The vaccine is frozen, since it is live, it is then mixed and is only stable for about 20 minutes after that. That is why it doesn't get mixed until it gets paid for

It is just under $180 at Costco - cash price.

It was only suggested for 60 and older, now FDA has dropped the suggested age to 50+ about a year ago.

[KingB]

I had the shingles shot at Walgreens early this year, covered under my UHC plan at 100%.

[Nords]

If you're covered by military Tricare and age 50 (not 60, but five zero) or over, then you may be able to get the shingles shot for free at your nearest military treatment facility. I think it depends on the size of the operation (Tripler Army Medical Center for us).

Even if it costs $250 out of your pocket, it's worth the expense. I've seen people in their 30s get shingles-- not pretty.

[mickeyd]

I received the shingles vaccine at the local military base hospital when I turned 60. Dw just received it this year at the federal clinic that she goes to. Both covered 100% by Tricare.

My Mom had shingles for several years before she passed away and suffered greatly from it's effects. The vaccine does not guarantee that you will not get shingles, but it lowers your chances of getting it.

[veremchuka]

I've been thinking about getting the vaccine shot for a few years but I hate the idea of injecting anything into me. You can draw blood all day and I'm fine with that but the injection part spooks me. So I finally looked into it and had it done yesterday at the pharmacy in a grocery store. The shot was covered by my medical coverage but there was a $30 administration fee. A small price to pay to hopefully avoid this dread disease.

[martyb]

Ok, I'm convinced. I'll see about getting the shot next week.

[Silver]

Quote:

Originally Posted by gromit I haven't had a shingles shot yet, but when I wanted a flu shot under my employer's UHC plan, they would cover it only if it was given in a doctor's office. I don't know why the plan's approved pharmacies were not also approved for giving flu shots.

My guess is that physicians who have contracted with UHC to accept the UHC discounted payments for services insist that UHC disallow coverage of non-physician services so they don't lose those billable dollars. Some physicians bill for a brief office visit just for the injection.

[gerrym51]

Quote:

Originally Posted by imoldernu We rec'd shingle shots 3 years ago, but it was on Medicare D. Shots were free, $6 charge for administering. A few things... First the shots must be refrigerated, and even at that have a short life (according to the pharmacist). Our local Walgreens advertised them on their outside sign a week ago. Don't know if this is a permanent thing. When we got ours, only one drugstore in town of 18,000 people offered the shots. At the time we did get ours, there were two local clinics that advertised free shots (plus a $20 service charge for administering), but that was a twice a year deal, and you had to know about the dates. Go to your state's senior services site for info on this kind of information....even if you're not 60 or 65.

i'm a pharmacist.refrigerate is Not correct. the shingles shot must be FROZEN and only thawed no more than 30 minutes before administration. this requires special freezers as most pharmacies have just the refrigerator with no freezer in them. even if you do the government requires a special freezer .

equiping all stores with these special freezers cost money-cvs has 8000 stores. now they usually have 1 store in a metropolitan area that has the freezer.

walgreens and Rite aid have decided to equip all stores with the special freezers-cvs has not

[martyb]

Quote:

Originally Posted by gerrym51 i'm a pharmacist.refrigerate is Not correct. the shingles shot must be FROZEN and only thawed no more than 30 minutes before administration. this requires special freezers as most pharmacies have just the refrigerator with no freezer in them. even if you do the government requires a special freezer . equiping all stores with these special freezers cost money-cvs has 8000 stores. now they usually have 1 store in a metropolitan area that has the freezer. walgreens and Rite aid have decided to equip all stores with the special freezers-cvs has not

Very good info...thank you for posting!