New Shingles Vaccine
09-10-2018, 08:10 AM
#12
Thread Starter
Shingrix is pretty expensive, so you might want to check with your health insurance first to make sure that it is covered, or if there is a copay.
If you are on Medicare already, I believe that it is covered under Medicare D (the drug plan), and you need to get it at a pharmacy rather than at your doctor office. In that case, if you did get it at your doctor office instead of a pharmacy, I don't think your doctor can submit a claim to Medicare D, and you would have to pay it yourself and then file a claim to get reimbursed.
So, you might want to check out all of these details first.
I am still covered under my husband's employee health insurance, rather than Medicare.
My doctor charged $260 for the vaccine itself (I think that is for both doses, but I'm not sure) and under the contract, our insurance plan paid her $168.
My doctor charged $36 to administer the vaccine and under the contract, our insurance plan paid her $30.41.
(Under the contract, the doctor cannot do any balance billing and has to write off the rest.)
There was no out of pocket cost to me and there was no copay, but that might not be the case for everyone's plan, so I would definitely check it out first so that you don't have any surprises. I've read that some people had some pretty unpleasant surprises.
If you are on Medicare already, I believe that it is covered under Medicare D (the drug plan), and you need to get it at a pharmacy rather than at your doctor office. In that case, if you did get it at your doctor office instead of a pharmacy, I don't think your doctor can submit a claim to Medicare D, and you would have to pay it yourself and then file a claim to get reimbursed.
So, you might want to check out all of these details first.
I am still covered under my husband's employee health insurance, rather than Medicare.
My doctor charged $260 for the vaccine itself (I think that is for both doses, but I'm not sure) and under the contract, our insurance plan paid her $168.
My doctor charged $36 to administer the vaccine and under the contract, our insurance plan paid her $30.41.
(Under the contract, the doctor cannot do any balance billing and has to write off the rest.)
There was no out of pocket cost to me and there was no copay, but that might not be the case for everyone's plan, so I would definitely check it out first so that you don't have any surprises. I've read that some people had some pretty unpleasant surprises.
09-10-2018, 08:20 AM
#13
I got it in 2009, so it must be the Zostavax shot. Based on your link, I quess it's worn off by now and I need the new one(s). Thanks for the heads up. That's more than I got from the doctors office.
Last edited by dlq04; 09-10-2018 at 08:26 AM.
09-10-2018, 08:57 AM
#14
Well since I've already exceeded my max out of pocket for 2018, I should get it this year.
09-11-2018, 05:08 AM
#15
We both had the old shingles shots a couple of years ago.
The new one, shingrix, is apparently hard to get around here.
CVS, who was giving the shots in the area, hasn't been able to bet any since April.
Our own doctor also hasn't recently been able to get any either.
We're now on a waiting list at both places.
Coincidentally, one night during the last week in August - the same week we were trying to line up shots - I developed a itchy red area on my back..
Wife said it looked like shingles [her father had had a bad case of it]. Quick visit to doctor next day ensued. He said he wasn't sure but it sure looked like it.
A 7 day, 3 pill a day prescription for valacyclovr cleared it up. Doc said I probably dodged a bullet and a good thing I didn't wait to see him. Another day and the drug probably wouldn't have worked.
The new one, shingrix, is apparently hard to get around here.
CVS, who was giving the shots in the area, hasn't been able to bet any since April.
Our own doctor also hasn't recently been able to get any either.
We're now on a waiting list at both places.
Coincidentally, one night during the last week in August - the same week we were trying to line up shots - I developed a itchy red area on my back..
Wife said it looked like shingles [her father had had a bad case of it]. Quick visit to doctor next day ensued. He said he wasn't sure but it sure looked like it.
A 7 day, 3 pill a day prescription for valacyclovr cleared it up. Doc said I probably dodged a bullet and a good thing I didn't wait to see him. Another day and the drug probably wouldn't have worked.
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S2KBobby (11-18-2022)
09-11-2018, 05:13 AM
#16
My mother had a terrible case of shingles, so I got the original shot when it first came out. I plan to call my doctor's office today to see if the new one is available. . . update: not available.
Paul, seems you did dodge a bullet.
Paul, seems you did dodge a bullet.
Last edited by dlq04; 09-11-2018 at 05:21 AM.
09-11-2018, 05:37 AM
#17
My son had shingles last year. It's not just an old people illness. He too got lucky and got to the MD's right away. He managed to continue working which was OK with his employer as long as the rash was not on his hands/face.
09-11-2018, 10:49 AM
#18
Community Organizer
I had Shingles 2 years ago at age 49. I believe I was told I was too young to get the vaccine at that time?
09-11-2018, 11:03 AM
#19
^
Insurance companies used to require the recipient be age 60+. Not sure if that still applies, or if it applies if one has previous history.
Insurance companies used to require the recipient be age 60+. Not sure if that still applies, or if it applies if one has previous history.
09-11-2018, 11:38 AM
#20
Thread Starter
goblueS2K's doctor's office called here at our home today to let him know that they received some Shingrix, and that they were setting one aside for him. He was high on their priority list since it is his second shot and he was supposed to get it yesterday, but when he got there they told him that they didn't have any. Someone messed up and didn't call him to tell him that.
(Not sure why the doctor's office keeps calling him here at home all of the time since he has told them to use his work or cell phone number.)
I immediately called goblue at work and told him, and suggested that he go right away to get it. (I'm not sure how many doses they got.)
So he called the doctor's office right back, and made arrangements to get the shot today. He left work, and has now received the shot already.
We'll see what happens on Oct 2 when I go for mine. I go to a different doctor, and I think I'll call a few days ahead of time to see if they have it.
(Not sure why the doctor's office keeps calling him here at home all of the time since he has told them to use his work or cell phone number.)
I immediately called goblue at work and told him, and suggested that he go right away to get it. (I'm not sure how many doses they got.)
So he called the doctor's office right back, and made arrangements to get the shot today. He left work, and has now received the shot already.
We'll see what happens on Oct 2 when I go for mine. I go to a different doctor, and I think I'll call a few days ahead of time to see if they have it.