Lainey

Had my checkup today. It's all good. I did ask about the shingles shot. My doc's office is also awaiting a shipment. She said to also check with my insurance company to see if they allow payment. My original shingles shot, which we know offers less protection than the new one, is still "good" so to speak. She also said Medicare does not pay for the shingles shot at the doctor's office but will at the pharmacy. I will have to call the pharmacy to ask for Rick. From what I read online the shingles shot is covered by Part D. Perhaps some of you still have "company" health insurance so your coverage may vary.

buckeyesue

Lainey, I did check ahead of time with our insurance company to make sure of our coverage for the new shingles shot. We are still under employee health insurance rather than Medicare, and it was covered for us at either the doctor office (a doctor in our plan) or a pharmacy under our employee health insurance plan.

The CDC says that the protection for the old shingles shot lasts only about 5 years.

Yes, that is true that the new shingles shot is covered under Medicare Part D, and should be gotten at a pharmacy rather than at a doctor office.

A friend of mine got the first dose (of the new one) at her doctor's office, and she had to pay for it, but she was able to get reimbursed later by Medicare. I don't know whether it was fully reimbursed or whether she had a copay.

I think she got the second dose at a pharmacy because of her experience with the first dose.

It does pay to check coverage ahead of time so that there are no surprises. I have read online of some people who had very unpleasant surprises about the cost, coverage, etc because they didn't check anything out ahead of time.

Lainey, it might be better to check with Rick's Medicare Part D insurance plan rather than the pharmacy. I know next to nothing about Medicare Part D, but perhaps he has to use a specific pharmacy that is in his Medicare Part D plan. Better yet, now that Rick is retired, perhaps he can make the phone calls himself.

Lainey

Good idea, Sue.

I just checked with my provider and I'm covered at the doc's office. In my case IF I had the shot at a pharmacy, I'd have to pay the $ and get reimbursed. Rick has preferred pharmacy for his Part D. I'll give them or his provider or Part D a call for him...he'll be making my lunch shortly, and he's on transportation duty for our granddaughter later today....he's a busy guy.

Lainey

PS. I don't have the number for his Part D carrier with me so I called his preferred pharmacy. They say he'd have a co pay of $163.40 for each shot. Considering how ill people get with shingles, I'm surprised they don't cover it in full. I will check with his Part D carrier too. Retail costs seem to vary. I've seen one at $280.00 and another showing at $342.00. The $160.00/dose does not make sense unless the higher retail cost applies.
Here's a good link where you can enter your zip code and Part D plan to find out your co-pay for this vaccine.
https://www.goodrx.com/shingrix/medicare-coverage

Jet sitter

The wife and I received our first shingrix vaccine yesterday. No side affects. The nurse said that if you don't have any issues within the first 3 or 4 hours, there wouldn't be any.

boltonblue

I'm "on the list" and patient-ly waiting..... you see what i did there...

Lainey

I too am on the waiting list. Rick is going to take a pass on this unless insurance coverage improves. He had the original shot.

dlq04

We are going to hold off until we determine what health insurance plan we select for 2019.

Lainey

One of the things I was told when I called to check on this is that Medicare covers pneumonia and flu shots. Your part D coverage is what covers the Shingrex shot. Coverage will vary widely as there are so many plans out there.

buckeyesue

Do you know how much the shots would cost if you get them in 2018 under your current retiree (?) health insurance?

I guess time is running out, though, to be able to get both shots in 2018 as the second shot is supposed to be 2 to 6 months after the first shot.

goBlue and I are still under employee health insurance, and fortunately both of the Shingrix shots for both of us were covered in full. We had no co-pay at all.