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Many customers getting ripped off on Flu shots

usa drugstores insurance coverage vaccinations beware

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#1 Hum

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Posted 25 October 2013 - 02:28

You really should get a flu shot.

But if you get one at a drugstore, you might find yourself wondering whether they're playing fast and loose with people's insurance coverage so the company can score some extra cash.

Paul Rubenstein, 39, has faced such a possibility for two years. The Mar Vista resident is insured by Anthem Blue Cross. His wife is insured by Health Net.

Last year, they went to a local CVS store for flu shots. The pharmacy worker ran both their insurance cards through the computer and said that neither insurer was covering vaccinations.

So Rubenstein and his wife paid about $30 each for the shots and went on their way.

This year, he decided to check in advance. Rubenstein called Anthem to ask whether he was covered for a flu shot. A company rep answered that, yes, he was covered.

So Rubenstein recently visited a nearby Albertsons and requested a shot at the store's Sav-On drugstore. The worker ran his insurance card through the system and said it didn't look as if Rubenstein was covered.

It was only after Rubenstein insisted that his insurer covered flu shots that the store worker tried the card again and, lo and behold, this time it showed he was covered.

An Anthem spokesman confirmed for me that flu shots are covered at most retail pharmacies.

Rubenstein said he later shared his experience with a colleague, who responded that she, too, had been told that her insurance didn't cover flu shots.

In her case, it was a Rite-Aid worker making the claim, and, as with Rubenstein, the pharmacy worker somehow managed to discover that coverage existed only after the woman stood her ground.

At this point, I'd be prepared to chalk all this off to coincidence. But then the same thing happened to me.

I stopped by a CVS store in West Los Angeles and requested a flu shot. I had been getting mine at CVS for the last few years, and each time it had been covered by my company's health insurer.

Not this time. The pharmacy worker checked the system and said that neither I nor my wife was covered for flu shots. If we wanted them, we'd have to pay about $30 each.

I contacted my insurer. A company rep was confused by the situation. "You're definitely covered for flu shots," she said. "CVS shouldn't be a problem."

So I went to a different CVS, this one with a so-called MinuteClinic staffed by a nurse practitioner. She ran my insurance card through the system and — what do you know? — it showed I was covered. :huh:

Should it make a difference whether someone seeks a flu shot from a CVS pharmacy or from a MinuteClinic? It shouldn't. They're both owned by the same parent company, CVS Caremark.

But Mike DeAngelis, a CVS spokesman, said the company's drugstores and MinuteClinics "are two separate practice settings and they contract for flu shot coverage separately."

"While many insurance plans are accepted by both CVS pharmacy and MinuteClinic for flu vaccinations, it is not uncommon for there to be some differences," he said.

DeAngelis emphasized that it's up to insurers and employers to select "a covered practice setting," even if those two practice settings are owned by the same company and are under the same roof.

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#2 FloatingFatMan

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Posted 25 October 2013 - 11:55

I got a flu shot a week or so ago. These are optional so are not covered by our NHS.  Cost me £7.50 at my local supermarket pharmacy, that's $12.15 US.  You guys are seriously ripped off...



#3 Knive Party

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Posted 25 October 2013 - 11:59

I've almost never had a flu shot in the last few years. I almost never get sick, so I guess that's why. And When I do get sick, it's like a mild cold with light symptoms for like 3 days max. Guess i'm lucky.



#4 XorpiZ

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Posted 25 October 2013 - 12:04

I'm glad I live in Denmark where I don't have to worry about stuff like this.



#5 Yazoo

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Posted 25 October 2013 - 12:04

I get mine free from my GP or through my work.



#6 notchinese

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Posted 25 October 2013 - 12:04

I got a flu shot a week or so ago. These are optional so are not covered by our NHS.  Cost me £7.50 at my local supermarket pharmacy, that's $12.15 US.  You guys are seriously ripped off...

 

And mine was free.....(American)



#7 vetneufuse

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Posted 25 October 2013 - 12:16

every store around me right now has free flu shots... without any insurance coverage... and all the major insurance carriers around here cover them for free.... (western Pennsylvania) heck most of the businesses around here that I know have company flu shot days were you can get them for free at work



#8 OP Hum

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Posted 25 October 2013 - 12:25

^ That's so they can get bad germs into you, then later charge a fortune for prescription meds. :shifty:



#9 vetneufuse

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Posted 25 October 2013 - 12:27

^ That's so they can get bad germs into you, then later charge a fortune for prescription meds. :shifty:

all our local stores have free antibiotics :laugh: so kinda rules that out also

 

but then the free antibiotics kinda make another problem, people over using them and getting immune bacteria....



#10 Growled

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Posted 25 October 2013 - 12:38

I know I have had problems with places telling me something isn't covered by my insurance, so I have to pay for it, and then they charge my insurance company and get two payments. You can't trust anyone these days.



#11 cork1958

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Posted 25 October 2013 - 12:38

Only get a flu shot if I happen to have a dr. appointment around that/this time of year. Am covered by our insurance.

 

Just had an appointment a few weeks ago, but apparently the vaccines weren't out yet. Dr. never asked if I wanted one and she's usually a stickler on this.

 

No scheduled appointments until my physical in March now! :)



#12 +Vykranth

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Posted 25 October 2013 - 12:41

Standard Vaxigrip flu shot: 6.14 Euros or 8.50 USD reimboursed 65% by Social Security, totally free for people over 65 or fragile people.

 

Number one problem of the US healthcare system: private companies motivated by profits, ripping customers off, certainly not Obamacare ...



#13 +Nik L

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Posted 25 October 2013 - 13:07

Thankfully my company provides them free



#14 vetneufuse

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Posted 25 October 2013 - 13:58

I know I have had problems with places telling me something isn't covered by my insurance, so I have to pay for it, and then they charge my insurance company and get two payments. You can't trust anyone these days.

If that ever happens, report it to your carrier immediately, and they will reimburse you for your payment and they will also go yell at the provider for doing it.



#15 +Bryan R.

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Posted 25 October 2013 - 14:08

Number one problem of the US healthcare system: private companies motivated by profits, ripping customers off, certainly not Obamacare ...

You're right about the first part and with the second save for the fact that Obamacare simply props up the current corrupt system.