New Shingles Vaccine
04-02-2019, 04:29 PM
#141
That's nuts! I don't think the vaccine actually costs that much. Are you sure the doc isn't "sticking" it to you? If the shot is administered in a doc's office there is no coverage from Medicare. Sounds like the doc is charging $$$ for the shot and $$$ for an office visit. At the pharmacy it is covered under Part D (with various co-pays). Your coverage may vary.
We had the shot at the Dr's office. The drug is $297 for each shot and the Doc is charging $104 for each shot.
No pharmacy around here has much -if any- and can't seem to get it in enough quantities to satisfy the demand
We have to pay the Doctor the entire amount and then submit it to our insurer for reimbursement.... They can't bill for it.
We have the paper work from our insurers and the paper work from the Dr's office we need to submit to the insurers.
My wife and I have different insurance but we're not sure how much we'll get back from each... yet.
It is MUCH cheaper to get it through a pharmacy like CVS but around here they have been unable to get much of it and the waiting list is VERY long. [At least 6 more months the last time we checked which was last week].
This whole thing is absolutely NUTS.......!!!!!!!!!
04-02-2019, 04:52 PM
#142
The $297/shot sees to be inflated, Locally, I've been quoted around $160.00/shot. When I checked for Rick, it was around $300.00 for both shots at the pharmacy.
With $300.00 total for the shot and two office visits for administration @104.00 each, you should be out $400.00 each...Let us know how you make out with reimbursement.
Something smells
if your doc is charging $800.00 each.
With $300.00 total for the shot and two office visits for administration @104.00 each, you should be out $400.00 each...Let us know how you make out with reimbursement.
Something smells
if your doc is charging $800.00 each.
04-02-2019, 04:52 PM
#143
Thread Starter
Trapper, I hope you have a good outcome in getting reimbursed from your insurance companies. I am optimistic that you will get reimbursed for at least part of your costs.
My doctor charged $260 for each shot, and $36 for each administration of the shot, so a total of $296 for each shot. The insurance company paid her almost $200 for each shot, and the rest was a write-off.
(I do not have Medicare Part D because I am covered under my husband's employee insurance plan.)
My doctor charged $260 for each shot, and $36 for each administration of the shot, so a total of $296 for each shot. The insurance company paid her almost $200 for each shot, and the rest was a write-off.
(I do not have Medicare Part D because I am covered under my husband's employee insurance plan.)
04-02-2019, 05:16 PM
#144
So the doc is marking up the drug by $100.00 and charging administration...as well. Obviously, docs don't get what they charge.
Medicare is a totally different ball game. When I checked for Rick I was told no coverage at a doc's office as it's a drug. Part D was the only option.
I did look up my charges for the first shot. Under 65, not on Medicare. In my case, I would not have been reimbursed if I had NOT received the shot at the doc's office. They (doc's office) "tried" to charge $459.00 for the ONE shot and $105.00 to administer. Insurance paid $140.00 for the shot and $43.24 to administer. That is fair. I paid $0.00
Edited!
Medicare is a totally different ball game. When I checked for Rick I was told no coverage at a doc's office as it's a drug. Part D was the only option.
I did look up my charges for the first shot. Under 65, not on Medicare. In my case, I would not have been reimbursed if I had NOT received the shot at the doc's office. They (doc's office) "tried" to charge $459.00 for the ONE shot and $105.00 to administer. Insurance paid $140.00 for the shot and $43.24 to administer. That is fair. I paid $0.00
Edited!
04-02-2019, 05:29 PM
#145
Thread Starter
So the doc is marking up the drug by $100.00 and charging administration...as well. Obviously, docs don't get what they charge.
Medicare is a totally different ball game. When I checked for Rick I was told no coverage at a doc's office as it's a drug. Part D was the only option.
I did look up my charges for the first shot. Under 65, not on Medicare. In my case, I would not have been reimbursed had I receive the shot at the doc's office. They (doc's office) "tried" to charge $459.00 for the ONE shot and $105.00 to administer. Insurance paid $140.00 for the shot and $43.24 to administer. That is fair. I paid $0.00
Medicare is a totally different ball game. When I checked for Rick I was told no coverage at a doc's office as it's a drug. Part D was the only option.
I did look up my charges for the first shot. Under 65, not on Medicare. In my case, I would not have been reimbursed had I receive the shot at the doc's office. They (doc's office) "tried" to charge $459.00 for the ONE shot and $105.00 to administer. Insurance paid $140.00 for the shot and $43.24 to administer. That is fair. I paid $0.00
04-02-2019, 05:37 PM
#146
04-02-2019, 05:37 PM
#147
I don't have Part D. I have a BCBS plan. I paid $0.
04-02-2019, 08:28 PM
#148
I haven't bothered to look in months. Its on my to-do-list. But, yeah, $800 each is robbery.
04-03-2019, 05:25 AM
#150
The $297/shot sees to be inflated, Locally, I've been quoted around $160.00/shot. When I checked for Rick, it was around $300.00 for both shots at the pharmacy.
With $300.00 total for the shot and two office visits for administration @104.00 each, you should be out $400.00 each...Let us know how you make out with reimbursement.
Something smellsif your doc is charging $800.00 each.
With $300.00 total for the shot and two office visits for administration @104.00 each, you should be out $400.00 each...Let us know how you make out with reimbursement.
Something smells
if your doc is charging $800.00 each.To complicate it even further our small local pharmacy -who we do most of our business with- was eligible to get the drug at a reduced price [but hasn't been able to so for months] but we'd have to get the actual shot from a doctor or a pharmacy that was licensed to give the shots since they aren't.
Our doc finally got some. We were at the top of his waiting list and way down on the lists of pharmacies around here so we opted to get the shots from him regardless of the cost.
Something smells fishy alright but I'm not sure it's the doctor's fault......They're just victims the screwed up drug situation in the US of A like the rest of us. .