PSA--Might be worth calling medical insurer to clarify coverage for Covid vaccines

[Acadie]

Cross-posting from booster thread--

My family had 8 Covid vaccine appts cancelled with CVS and Walgreens at different times. One was definitely due to lack of vaccine, but I wondered if some were because our insurance wasn't going through. 

When I called our insurance co, they said since Covid vaccines have been privatized we have to stay in-network for coverage. For our plan that means Discount Drug Mart, Giant Eagle, Rite Aid, Marc's, Meijer and CVS.

Except CVS is having trouble converting their billing and there have been tons of issues, the rep said. And Walgreens is out of network, so that's a nope even though we got Covid vaccines there before. Dd21 ended up finding appts online at a random Meijer 30 min from our house. 

Nutshell is it may be worth calling your insurance co, especially if your appts are getting canceled, because this is a total mess right now. I never would've guessed what was in and out of network for us, since it's covered by our medical plan which has a completely different network of pharmacies than our pharmacy plan! 

 

Edited September 29, 2023 by Acadie

[Frances]

This. Suddenly vaccine providers really care about insurance coverage because the federal subsidies are gone. I took an elderly neighbor with me when I got mine. She has excellent triple insurance and regularly uses this place for prescriptions and has gotten vaccines there before. It took them probably half an hour to go through all of her info and be sure which insurance company was going to pay for it before they would give her the shot.

Edited September 29, 2023 by Frances

[rebcoola]

Yes my parents had to find a new place to go to because of insurance.

[Acadie]

19 minutes ago, Frances said:

This. Suddenly vaccine providers really care about insurance coverage because the federal subsidies are gone. I took an elderly neighbor with me when I got mine. She has excellent triple insurance and regularly uses this place for prescriptions and has gotten vaccines there before. It took them probably half an hour to go through all of her info and be sure which insurance company was going to pay for it before they would give her the shot.

Thank you for helping your neighbor get her vaccine! It's so weird we can't go to our usual pharmacies. 

9 minutes ago, rebcoola said:

Yes my parents had to find a new place to go to because of insurance.

Your stories are making me realize what a disaster this is for elders and anyone else who may not have the bandwidth to make 8 attempts to schedule their updated vaccines during a surge, for heaven's sake! Huge mistake, in my view, to end the pandemic emergency and privatize Covid vaccines, testing and treatments, all of which have reverted to access-only-for-the-privileged. 

Thinking I may check in with the older generation among my family and friends.  

Edited September 29, 2023 by Acadie

[Idalou]

If you have an elderly relative who has basic Medicare, not Advantage, it's no problem at all. No charge, no copay, just show the Medicare card. That applies to any recomended immunization as of this year, even the shingles shot. 

[Acadie]

3 minutes ago, Idalou said:

If you have an elderly relative who has basic Medicare, not Advantage, it's no problem at all. No charge, no copay, just show the Medicare card. That applies to any recomended immunization as of this year, even the shingles shot. 

Medicare plans can have network pharmacies, but hopefully they're the same for both medical and pharmacy benefits? That would prevent the different pharmacy network problem. 

[J-rap]

I was just hearing that insurance is supposed to cover it, but there's been a problem with some pharmacies getting that set up.  So yes, you might want to call first until they get it straightened out.

[MercyA]

Our county health department is doing Covid and flu shots for free. 

[Acorn]

Walgreens canceled our appointments last year due to staffing shortages. Some of my family received vaccines there this week, and the pharmacy staff was vocal about being overworked.

Edited September 29, 2023 by Acorn

[Frances]

3 minutes ago, Acorn said:

Walgreens canceled our appointments last year due to staffing shortages. Some of my family received vaccines there this week, and the pharmacy staff was vocal about being overworked.

Some pharmacies here started hiring nurses last fall just to give shots, so you don’t have to wait for a pharmacist to be free. Pharmacy staff being overworked at chain pharmacies is a major problem, even without adding in an ever growing number of vaccines. We are fortunate that our insurance plan allows us to avoid them and choose those have appropriate staffing levels.

[Acadie]

3 hours ago, Frances said:

Some pharmacies here started hiring nurses last fall just to give shots, so you don’t have to wait for a pharmacist to be free. Pharmacy staff being overworked at chain pharmacies is a major problem, even without adding in an ever growing number of vaccines. We are fortunate that our insurance plan allows us to avoid them and choose those have appropriate staffing levels.

Health care workers, pharmacy staff, educators and school staff are all stretched so thin these days! Feeling like we need to better appreciate, staff and remunerate all kinds of caring professions.

[MEmama]

We got our Covid and flu shots yesterday and weren't even asked about insurance? The pharmacy just rang it up as no charge 🤷‍♀️

It wasn't our typical location or pharmacy chain, or even in our town.