Has anyone experienced a $185-242 copay for a Shingrix shot?? That is what I have been quoted.

GeorgiaXplant

Well-known Member
Location
Georgia
Is it your Part B plan or your Part D plan that it is billed to??
I have no idea. There is no copay for vaccines with Kaiser Senior Advantage.

ETA: Now that I think about it, it would have been billed to Part B. Part D is for prescription meds. I don't understand why you would have been "quoted" a price. Check your policy. If you can't find the answer there, call your insurer and ask what your copay would be.
 
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I have no idea. There is no copay for vaccines with Kaiser Senior Advantage.

ETA: Now that I think about it, it would have been billed to Part B. Part D is for prescription meds. I don't understand why you would have been "quoted" a price. Check your policy. If you can't find the answer there, call your insurer and ask what your copay would be.

Yup, that's the best way to get correct and current information. The folks giving the vaccine usually don't have a clue what a particular insurance carrier (or even plain Medicare) will actually pay.
 

oldpop

Member
Location
Ross Island ATA
I do not know about your exact situation. I have Medicare and sometimes it takes them a while to pay their part even though the provider may have already billed them. When that happens I get a bill for the full amount but Medicare eventually pays their part. The first time this happened to me I called the provider and that is how it was explained to me. My suggestion is to call the provider and ask them if they have submitted the bill to your insurance yet. I hope this helps.
 
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Aunt Bea

SF VIP
Location
Near Mount Pilot
I believe that the Medicare reimbursement for some vaccinations have changed within the last year or two.

Both of my Shingrix shots were no cost to me at the time.

Check with your insurance provider and also check with the Shingrix website for discount coupons.
 

Colleen

Member
Location
Arizona
Are you talking about a shingles shot? If so, hubby and I got ours about 2 years ago at a local pharmacy (because our "doctor" at the time, didn't give shots in his office...not even the flu vaccine) and our insurance didn't cover one penny. We paid almost $600 for our shots and then several months later, I found out they were the "old" shingles vaccine and were only 30% effective.
 
Are you talking about a shingles shot? If so, hubby and I got ours about 2 years ago at a local pharmacy (because our "doctor" at the time, didn't give shots in his office...not even the flu vaccine) and our insurance didn't cover one penny. We paid almost $600 for our shots and then several months later, I found out they were the "old" shingles vaccine and were only 30% effective.

Oh no, sorry to hear that. I guess the Shingrix was approved by FDA in 2017. I have postponed this a long time,
 

OneEyedDiva

Well-known Member
Location
New Jersey
I remember my insurance used to cover it years ago, now they don't. I didn't get it though because at the time, I wasn't impressed with the efficacy and didn't know what was in it. I felt that boosting my immune system was a better option. I sure hope it works for me because my niece is among those I know who suffered with shingles and none would wish it on their worst enemy.
 

Kaila

SF VIP
I remember my insurance used to cover it years ago, now they don't. I didn't get it though because at the time, I wasn't impressed with the efficacy and didn't know what was in it. I felt that boosting my immune system was a better option. I sure hope it works for me because my niece is among those I know who suffered with shingles and none would wish it on their worst enemy.
I didn't get it in past decades, either, due to the old one having been a live vaccine.
That one has now been completely discontinued in the USA, and the newer one is not live, and has lots of good data now, so I might get it. That's true that having a shingles episode is very common, and an awful experience.
Of course, I agree that doing other things to boost our health is great, whenever possible.
 
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Kaila

SF VIP
Past decades? The first shingles vaccine was only licensed in 2006, fifteen years ago.

Gosh, I am sorry. I apologize to everyone, for that error I made! :(

I first had written the above post, without that word, and then put it in, which is obviously by mistake.

I know I had considered , for some years, whether to have that previously available shingles vaccine, and I did not have that one, and now they do have a better one. (Shingrix is safer, and higher effectiveness)
I hope to get that one, at some point.
I think the pharmacist at Walgreens told me it is a 2 dose one, with the interval between the 2 doses, I cannot remember, perhaps a month.

Thanks to this thread, I will not be shocked if it has a significant co-pay.
 
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Colleen

Member
Location
Arizona
When we got ours (and had to pay almost $600!), we were not aware there was a "newer" version and that it was way more effective. The pharmacist never said a word. Just another reason we quit dealing with that pharmacy. The other reason was...they filled a Rx of mine that I was allergic to but never flagged it or took it out of my profile. It was a good thing I looked at my label before I paid for it and took it home.
 

Kaila

SF VIP
The 2 doses of the Shingrix vaccine, are advised to be done at an optimal interval of sometime between 2-6 months, between the 2.
 

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